Introduction to the theme ‘Reducing the risk of chronic diseases in general practice/family medicine’
The primary cause of death in Europe is chronic disease. Cardiovascular disease and diabetes alongside chronic obstructive pulmonary disease and cancer are among the four main chronic diseases. Premature death is a major consideration when evaluating the impact of chronic diseases on a given population and is used as an indicator in the global monitoring framework. During the EGPRN spring conference in Riga, Latvia, oral and interactive posters were presented alternately. Papers on ‘Screening Programme,’ ‘Prevention of Non-communicable Diseases,’ ‘Life Style Behavioural Changes’ and ‘Personnel Resources (Burnout Syndrome)’ were discussed among an international audience of family doctors and general practitioners.Although chronic diseases are the most common and costly health problems, they are also the most preventable. Prevention is health promotion activities that encourage healthy living and limit the initial onset of chronic diseases but it also includes early detection activities, such as screening at-risk populations as well as strategies for appropriate management of existing diseases and related complications. As general practitioners/family physicians, we spend most of our time caring for patients with chronic diseases but studies show that we achieve the standard of care for chronic diseases and preventive care for less than 50% of the patients.Is our healthcare system designed to prevent chronic illnesses? Can the traditional physician–patient interaction, which is organized to respond to acute patient illness, be as effective in managing chronic diseases?Studies of chronic disease prevention and management based on the Chronic Care Model (CCM) show promising results in reducing the healthcare costs, improving performance and health outcomes. CCM enhances the role of multidisciplinary primary healthcare. Although chronically ill clients value a single source of care for their multiple needs, the complexity of the same needs means that no single professional can provide the expert care. An interdisciplinary mix of primary care professionals, working in organized teams, has been shown to improve care for the chronically ill, and provide effective prevention. Cochrane Collaboration review confirmed that multicomponent practice changes in four categories led to the greatest improvements in health outcomes: increasing providers’ expertise and skill, educating and supporting patients, making care delivery more team-based and planned, and making better use of registry based information systems. Although full implementation of the chronic care model is highly demanding because needs involve the entire healthcare system and the community, many of the features can also be implemented in smaller practices.