by Victoria J. Barr, Sylvia Robinson, Brenda Marin-Link, Lisa Underhill, Anita Dotts, Darlene Ravensdale and Sandy Salivaras

Chronic disease is an international concern. The increasing incidence of chronic diseases is approaching epidemic levels. Chronic disease is a strain on individuals and on healthcare systems. Finding evidence-based and effective strategies to promote health and to prevent and manage chronic diseases is essential. The current situation is not encouraging. Multiple studies demonstrate that guideline-directed chronic disease care is not the norm.

A variety of changes for the management of chronic disease care have been advocated. Renders et al. (2001) concluded after a Cochrane review that the most effective interventions for improvements in chronic disease care include the combination of multi-pronged strategies. The Chronic Care Model (CCM) is an example of this type of approach. The model has been implemented by a large number of organizations in the United States, the United Kingdom and Sweden through the Chronic Illness Breakthrough Series conducted by the Institute for Health Care Improvement. Initial results of testing the model are encouraging (Wagner et al. 2001).

Proponents of the CCM have suggested that it can also be used for the prevention of chronic disease. Glasgow et al. (2001) theorize that change will be less costly and more effective if both clinical prevention and management of chronic disease use a similar set of improvement strategies. Their paper concludes that the CCM can be used to direct quality improvement initiatives for clinical preventive services. However, Glasgow and his colleagues acknowledge that the “scope and depth of the community resources and policy-linkage components of the CCM may need to be expanded” (Glasgow et al. 2001 79: 602).

This article examines: (a) the challenges to the current CCM, (b) the evidence for population health promotion and (c) a proposal to expand the existing CCM to include elements of population health promotion.

Taken from: Healthcare Quarterly, 7(1) 2003: 73-82

This entry was posted on Monday, May 7th, 2012 at 5:40 pm and is filed under Longwoods Online.