Managing Chronic Disease in the Primary Care Setting
Caring for clients with a chronic illness will mean multiple visits and careful managing of
their plan of care to include medications, screening exams, and referral. More than 75% of
all health care costs in the United States due to chronic illness. The impact that this has on
the healthcare system is staggering. With the population aging and more chronic illness
occurring, it has never been more important to properly manage this epidemic through the
use of cost-effective, evidence based care where it begins: In the primary care setting.
In a 4-5 page APA paper with a minimum of three APA references,
�Discuss the impact of chronic disease on health care as a whole.
�Examine how evidence based plans of care can reduce the health care cost burden placed
on Americans and discuss cost effectiveness achieved by the use of evidence based plans of
�Discuss the role that advanced practice nurses play in caring for patients with chronic
illness from the standpoint of health promotion, medication management, and symptom
management, and the importance of this role.
The finished Assignment should be a 4-5 page descriptive and exploratory essay, excluding
the title page and references. The viewpoint and purpose of this Assignment should be
clearly established and sustained.
Managing Chronic Disease in the Primary Care Setting
Chronic diseases have effects on the population, family, sustainability of the health care
system, and economy as a whole. The most affected people are those above the age of 12.
However, some children are born victims of diseases like HIV/ AIDs. Chronic diseases include
cancer, chronic pain, diabetes, heart disease, kidney disease, lung disease, stroke and HIV/ AIDs.
Patients who are victims of these chronic diseases leave their old way of living and have to adapt
to new ways of living. Some of their affected areas are aspiration, lifestyles and employment.
Many are found grieving before adjusting to their new systems. Others develop distress and
psychiatric disorders like depression and anxiety.
MANAGING CHRONIC DISEASE IN THE PRIMARY CARE SETTING 2
A study that was conducted recently indicated that 13% of men and 17% of women with
chronic diseases are affected by depression and anxiety before they adapt to their new ways of
living (Consultation, W. H. O. 2000). It is sometimes difficult to diagnose depression. The
commonly known symptoms include lack of good sleep, poor appetite, and lack of energy
However, it is good to diagnose and treat the depression early because it can make the patient
lack the need for the treatment he is receiving. The development of chronic disease to a person
who was previously mentally unstable may lead to exacerbation of their symptoms, which may
result to worsening of their functioning. The doctors have a big role of making patients
understand their conditions so that if they are capable, they can make their own decisions. The
mental illnesses have physical consequences to patients. After depression, the dangers of
myocardial infarction may increase to five fold. Patients with chronic illnesses sometimes incite
feelings of anxiety and inadequacy and, thereby, becoming emotional loads to the psychiatrist
attending them. The same psychiatrists may be affected by the losses suffered by the affected and
his family in one way or another. They also have a major role of maintaining hope to the
patients. They should be free to discuss the fears and anxieties of the students and keep them
with a positive outlook.
The chronic diseases create an economic burden. The GDP is reduced. It is not only those
suffering from the diseases who affect the economy but also those productive in the economy are
affected (Consultation, W. H. O. 2000). The ones suffering may have been participating in
production. If the rate of chronic diseases is not reduced there will be increased economic
damage to the country. The chronic diseases consume $1.3 trillion annually, where $1.1 trillion
represent the lost productivity. Surviving with a chronic disease and caring for a victim of
chronic disease leads to stress. The family is financially affected where some even go to an
MANAGING CHRONIC DISEASE IN THE PRIMARY CARE SETTING 3
extent of borrowing friends and families to settle the medical bills. It may cause family violence
as they may sometimes start blaming each other. Some of them develop emotional illness and
may express it through anger and physical violence. Others develop anxiety, feel denied,
dissatisfied with life, exhausted and depressed. The ones caring for the sick consume a lot of
time and energy spending with their loved ones instead of engaging in activities of development.
They feel pressured by making the effort of taking care of the sick and having a life which is
different from the one she is used. The disease affects the whole household of the sick. Those
who work with the patients, those who care for the patients and those who love the patient are
affected too. Generally the community and the nation are affected as a whole (Consultation, W.
H. O. 2000).
Capitalizing in decent well-being can lead to reduced cost of medicine used on those
living with chronic diseases. With improving on the prevention and early treatment of the
chronic diseases, large amounts can be saved. Assuming modest advances in the prevention and
the treatment if modest diseases. Milken Institute researchers have faith that by the year 2023,
the nation will be in a position to avoid around 40 million cases of chronic diseases and, thereby,
lowering their negative economic impacts by 27% per year. To reduce the cost accumulated by
the chronic diseases, prevention and early diagnosing and treatment of chronic diseases should
be established and people should be offered education on control of obesity. Chronic disease
management has approaches which can improve the health outcomes of the chronic diseases
(Marks & Allegrante, 2005).
The United States of America has achieved reducing the cost of chronic diseases where
the government has taken the responsibility of changing the environment by for example,
regulating the tobacco products and the products which are used to make the food people
MANAGING CHRONIC DISEASE IN THE PRIMARY CARE SETTING 4
consume. They have also intervened on the taxation, reforming the already existing environment,
and banning of advertising. At the community level through the actions delivered to them, for
example those based on the schools and work place health promotion, the education offered to
the community, training and campaigns on public awareness. To the sick patients, they have
received screening, counseling, chemoprophylaxis and immunizations to those who are not
victims yet. Chronic care requires a specialists who are experts in dietary education and
rehabilitation, a spiritual leader to provide counseling and hope to the affected people and nurses
who take the general role of taking care of the sick patients. In the 1970s, the nurses started
receiving training and education on how to take care of sick patients which involved long periods
of training. While these exceptional care programs run by nurses may light the needs of the large
number of people with chronic diseases who get attention at tertiary centers, they are not as
viable for persons receiving care in a general ground. In most cases, it is not only chronic
diseases, but a multitude of conditions which affect the patients (Allen, 2002).
The nurses play a vital role to the chronic disease affected patients. From the physical
care by providing the medication required, they are also trained to give hope to the sick patients
giving them emotional support. They ensure the patients take medication as prescribed, inform
the doctor on the progress of the patients, and ensure they eat their meals as required (Allen,
2002). That ensures the patients get their right in hospitals. Emotional support keeps the patients
in peace and for those who may have lost hope restores it. For example, those affected by HIV
and aids can live many more years because they are given advise on how to view the disease as
not killer but when managed, one can live many years. By guidance and counseling, the patients
are educated on the diet which suits them, the exercise they are supposed to do and what they are
MANAGING CHRONIC DISEASE IN THE PRIMARY CARE SETTING 5
supposed to avoid, for example, unprotected sex. The relatives and friends of the affected are
informed on how to treat the sick with love and care.
Allen, D. (2002). The changing shape of nursing practice: The role of nurses in the hospital
division of labour. Routledge.
Consultation, W. H. O. (2000). Obesity: preventing and managing the global epidemic. World
Health Organization technical report series, 894.
Marks, R., & Allegrante, J. P. (2005). A review and synthesis of research evidence for self-
efficacy-enhancing interventions for reducing chronic disability: implications for health
education practice (part II). Health Promotion Practice, 6(2), 148-156.