Chronic disease management

Arnold R. Implementing automated chronic disease management support systems in asthma the promise and the pitfalls. Critical Issues in eHealth Research Conference. Bethesda, MD, 2005. 

Effectiveness of shared care across the interface between primary and speciality care in chronic disease management... 

Stuart, M. and Weinrich, M. (2004) Integrated health system for chronic disease management lessons learned from France. Chest, 125, 695-703. Maltais, F. and Debigare, R. (2003) Biology of muscle impairment in COPD. Monaldi Archives for Chest Disease, 59, 338-341. 

PTG. finally, the PTG includes several classes of molecules whose therapeutic potential is only now being realized, such as both intracellular and extracellular kinases and phosphatases, as well as cell adhesion molecules. These classes of targets represent over 1000 potential novel points of intervention for chronic disease management The size of each protein family, and their distribution according to target type, is presented in Pig. 4.3. 

Many of the previous research work show that guidelines disseminated throu traditional educational interventions have minimal impact on physician behaviour. Providing focused training to key people in a practice and supporting sub-specialisation through computer decision support may be a more appropriate approach to chronic disease management in primary care ... 

Best practice in chronic disease management in the primary and community care sector Education, training, and quality improvement Cancer-screening program registers... 

Stuart M, Weinrich M. Integrated health system for chronic disease management lessons learned from France. Chest 2004 125 695-703. 

DeBusk RF, West JA, Houston Miller N, et al. Chronic disease management. Arch Intern Med 1999 159 2739-2742. 

Wagner EH. The role of patient care teams in chronic disease management. BMJ 2000 320 569-571. 

Taylor SJC, Candy B, Biyar RM, et al. Effectiveness of innovations in nurse led chronic disease management for patients with chronic obstructive pulmonary disease systematic review of evidence. BMJ 2005 331 485. 

Methotrexate has been used successfully with cyclosporine, either concurrently34 or in rotation. Rotational therapy is particularly effective since it minimizes the serious adverse effects of both agents hepatotoxidty from methotrexate and hypertension and nephrotoxicity from cyclosporine. Having an overlapping treatment period may not be necessary and patients have been successfully switched after a 1-week washout period.21,35 This is a very useful combination of systemic agents in the longterm management of this chronic disease. 

See Chap. 46, Chronic Kidney Disease Progression-Modifying Therapies, authored by Melanie S. Joy, Abhijit Kshirsagar, and Nora Franceschini, and Chap. 47, Chronic Kidney Disease Management of Complications, authored by Joanna Q. Hudson, for a more detailed discussion of this topic. 

However, the public has not abandoned conventional medicine for alternative healthcare. Most Americans seek out alternative therapies as a complement to their conventional healthcare whereas only a small percentage of Americans rely primarily on alternative care. Why have (30) so many patients turned to alternative therapies Frustrated by the time constraints of managed care and alienated by conventional medicine s focus on technology, some feel that a holistic approach to healthcare better reflects their beliefs and values. Others seek therapies that will relieve symptoms associated with chronic disease, symp-(35) toms that mainstream medicine cannot treat. 

Ralph s case illustrates that managing addiction, like managing a chronic disease, constitutes work and that the context of that work is... 

In this and other reviews the lack of long-term data, which is particularly important for understanding the management of a chronic disease that requires many years of therapy for an individual, has been discussed. Data from 4-year open studies suggest that lung function does not deteriorate compared with subcutaneous insulin. However, patients with lung disease have usually been excluded from such studies (276,277). 

Tetracyclines also seem to have anti-inflammatory and immunomodulating effects.53,71 Although the exact reasons for these effects are unclear, tetracyclines have been used in a variety of noninfectious diseases with an inflammatory or autoimmune basis, including scleroderma and rheumatoid arthritis.71 Clinical studies will continue to investigate how these drugs can be used effectively in the long-term management of chronic disease. 

About the Author Dr. Mosavin is Chair of the Department of Pharmaceutical Sciences and Associate Professor in the Department of Pharmacotherapy and Outcomes Science at Loma Linda University s School of Pharmacy. Dr. Mosavin received a B.S. in Pharmacy from the University of Kansas, a Ph.D. in Pharmaceutical Sciences from the University of Wisconsin—Madison, and an MBA from the University of Chicago. Dr. Mosavin has experience in pharmaceutical industry, hospital pharmacy, and ambulatory care pharmacy settings. His research interests encompass economic evaluation of health care delivery systems and the role of pharmacists in these systems (especially as it relates to management of chronic diseases by pharmacists). Another key area of his research is analysis of economic gains achieved by health information technology implementation in ambulatory care pharmacy practice. 

Genetics has emerged as an essential discipline to gain knowledge conducting to further understand and properly manage some of the most prevalent chronic diseases of our society such as cancer. 

Workers are potentially exposed to a variety of substances during daily industrial operations. The OSHA estimates that a large segment of workers are simultaneously exposed to more than one substance and suffer from adverse effects. Adverse effects include many acute and chronic diseases (e.g., allergic sensitization, cancer, cardiovascular diseases, dermatitis, erythema, edema, irritation of the mucous membrane, irritation of the skin, kidney disease, liver disease, metabolic interferences, narcosis, neuropathy, ocular effects, odor effects, respiratory diseases, systemic toxicity). These should be properly addressed by concerned management and the individual worker to improve chemical safety. Workers come in contact directly or indirectly during different work conditions hence it is important to understand the possible adverse effects that these chemicals may cause vis-a-vis chemical safety. 

NICE (National Institute for Health and Clinical Excellence) (2004) Chronic obstructive pulmonary disease - Management of chronic obstructive disease in adults in primary and secondary care. Available at http //www.nice.org.uk/nicemedia/ pdf/CGOl 2 niceguideline.pdf [Accessed 4 June 2008],... 

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