Managing chronic disieases

Managing chronic diseases

Chronic diseases are illnesses that cannot be prevented by vaccines; they are neither cured by medication nor do they just vanish. Chronic diseases are more common with age.  This circumstance plagues older adults majorly in the developed nations with the leading chronic illness being; arthritis, cardiovascular disease e.g. stroke and heart attack, cancers e.g. breast cancer colon cancer, diabetes, obesity among others

Studies done in the United States shows that seven people out of ten deaths in the United States are as a result of forms related to chronic conditions. Fifty percent of those diseases have been caused by heart attacks, cancer, and stroke each year. It has been proved that nearly half of adults in the nation have been diagnosed at least with one chronic illness. Also, more than one person in every three adults has a fitting clinical classification of obesity, one in five children being classified as obese. There has been a worrying raise in diabetes where the trend show that out of every three born babies one will suffer from a diabetes infection at one point in their lifetime. The  Rates of chronic disease among ethnic minorities and lower-income earners are higher than the national standard and are thus a concern particular.  The ethnic minority communities experience elevated rates of heart disease, stroke, cancer, obesity, and diabetes.  Chronic illness, therefore, impacts all Americans, but not equally nearly 40 percent of children are overweight or obese Within the African America demographic

The chronic disease does not affect only the health of the individual and their families, but it has a broader impact on our communities and the economy. According to  Centers for Disease Control and Prevention (CDC), chronic diseases spend more than 75 percent of the annual money spent on health care. Billion have been spent in health costs in the treatment of all cardiovascular diseases, diabetes, obesity, lung disease and lost productivity annually. Regarding public insurance, management of chronic illness amount to yet a larger percentage of spending.The Society and business also incur the meandering costs of these conditions, including absenteeism, disability, and reduced productivity. (“The State of Chronic Disease Prevention”, 2016)

Chronic disease affects the physical condition and quality of life, but it is also a major driver of health care costs and has a linked force on commerce such as absenteeism. Poor health of a population applies tremendous force on employment rates, interest, and other concrete factors that in due course affect the ability to sustain a healthy global financial pose.

In most cases chronic diseases are viewed to have a notable harmful impact on the psychological health of relatives than their straight psychological effects on the patient. Economic suffering not only directly raises the possibility that an individual will experience emotional anguish, but it appears it also diminishes the family’s capability as a whole to manage expressively with chronic illness. (“Why We Need Public Health to Improve Healthcare – National Association of Chronic Disease Directors”, 2016)

Due to psychological distress contagiously confronting the families with chronic infection, efficient treatment strategies may need to be targeted to all the relatives of the primary patient’s family. Providers should be particularly watchful for intra-family effects when their patients come from families that lack the economic resources that might protect against the stress of caring for a family member with a chronic illness.

For the realization of effectiveness cost reduction in health to take place consideration has to be taken on evidence-based plans. However, it is important to ensure that all pathways are not created equally.  Majority programs use least criteria to develop their routes these frequently include evaluation of efficiency and toxicity. A few pathway programs go past these minimum criteria and regard costs as well. These types of programs outline management alternatives based on utmost survival benefits, least toxicity, and advantages in cost-saving. With empirical studies suggestions, evidence-based plans improve patient results and the NSCLC study showing that evidence-based programs also actually reduce the costs of chronic diseases care, e.g., cancer, there is more reason for oncologists to adopt standards of care.

In an evaluation of various evidence-based plan programs, consideration of various points possibly will help to ensure greatest benefits; the points are therefore individually joined to the process of pathways development. First, A multidisciplinary task force of physicians and pharmacists should work together to create the pathways. Secondly, the task force should base the pathways on a wide-ranging review of accepted clinical evidence from a collection of sources, including in print, peer-reviewed outcomes data. Thirdly, Pathways should be the focus on a continuing review process that continually evaluates new agents and the most up-to-date data on health results.

When efficiency and toxicity for agents are approximately the same, the pathway should factor cost into the equation. The following evidence-based plans factors, therefore, are considered reduction of health care cost;

Firstly, there is Use of Less Expensive Drugs Oncology medicine costs are very expensive, making this line item an understandable aim for payers as they look for ways to decrease costs. One of the ways evidence-based plans help reduce the costs of cancer care is by optimizing the suitable use of less costly drugs. A developed pathway supports the use of less expensive remedy, without compromising outcomes or increasing toxicity. Secondly, Decrease in Therapy Overall .healing procedure, backed by evidentiary support, lead a general practitioner to assertively advocate the most effective treatment as the first-line treatment with ordinary order sets that describe dosing potency and amount of cycles. For example. For many cancers, particularly solid growth in adults, each successive line of treatment is less efficient than the preceding line. When patients with late-stage illness face complex decisions, some will desire to carry on a line of treatment no matter what. The patient’s and the family’s state of life should, therefore,  reduce the costs bear by the family and payers by shunning preventable and ineffective chemotherapy administered within a few weeks of death.

Thirdly, decrease in costly Supportive Care Drugs. When two or more treatment is similarly efficient against an infection, the course of therapy lower in toxicity are classically chosen to be on-pathway. This leads those doctor who adheres to pathways to be less likely to prescribe pricey anti-emetics, development factors, and other supportive care drugs absent substantial evidence to legalize their use.(Michael A. Kolodziej, 2016)

Nurses play an essential role in the endorsement of public health. Traditionally, the focus of health promotion by nurses has been on disease avoidance and varying the behavior of persons on their health. However, their role as advertisers of health is more complicated, since they have multi-disciplinary knowledge and experience of health promotion in their nursing practice.

The role of nurses comprises clinical nursing practices, consultation, follow-up treatment, patient instruction and disease prevention. This has enhanced the accessibility of health-care services, abridged signs of chronic diseases, improved cost-effectiveness and improved customers’ understanding of health-care services

Also, health promotion by nurses can lead to many positive health outcomes including adherence, quality of life, patients’ knowledge of their illness and self-management.

Health advertising was begun to emphasize the community-based system of health promotion, community participation and health promotion practice based on social and health policies. The notional foundation of health promotion replicates the type of realistic actions taken on by nurses to promote the physical condition of patients, families and communities. Therapists work from both a holistic and patient-oriented speculative basis or take chronic diseases and medical-oriented approach. The theoretical foundations represent the chief concepts of health promotion orientation and public health orientation in this review

Nurses’ strategies for health promotion include giving patients information and education health provision (Kemppainen, Tossavainen & Turunen, 2012)

The role of nurses under management involves Selection, evaluation, and guidance on the development of staff, Establishment of operational policies and procedures. Nurses also monitor and ensures there is environmental safety, and the quality of services delivered to establish organizationally is efficient. Advanced nurses function in various roles including nurse practitioners, clinical nurse specialists, case managers, administrators, educators, researchers, staff nurses, and consultants. The Association Nurses suppose that the role of the advanced practice rehabilitation nurse is a valuable asset to medical practice and is essential for the continued growth and expansion of nursing as a discipline. Advanced nurse functions as a role model for other nurses. The value of the nurses practice is measured by improved cost-effectiveness of patient care, improved nursing staff clinical knowledge and skill, reduced incidence of the impediment for the patients, and increased quality of nursing care.


Why We Need Public Health to Improve Healthcare – National Association of Chronic Disease Directors. (2016). Retrieved 13 April 2016, from

The State of Chronic Disease Prevention. (2016). Retrieved 13 April 2016, from

Michael A. Kolodziej, M. (2016). Does Evidence-Based Medicine Really Reduce Costs? | Cancer Network. Retrieved 13 April 2016, from

Kemppainen, V., Tossavainen, K., & Turunen, H. (2012). Nurses’ roles in health promotion practice: an integrative review. Health Promotion International, 28(4), 490-501.

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