PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “CHRONIC DISEASE”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed2005

Readmission patterns in patients with chronic obstructive pulmonary disease, chronic heart failure and diabetes mellitus: an administrative dataset analysis.

Comprehensive disease management programmes for chronic disease aim to improve patient outcomes and reduce health-care utilization. Readmission rates are often used as an outcome measure of effectiveness. This study aimed to document readmission rates, and risk for early and late readmission, for patients discharged from the Royal Melbourne Hospital with a disease diagnosis of chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) or diabetes mellitus compared to those with other general medical conditions. Eighty five (8.6%) of patients were readmitted within 28 days and 183 (20.8%) were readmitted between 29 and 180 days. No risk factors for early readmission were identified. Patients with a primary disease diagnosis of CHF and COPD are at increased risk of late readmissions (29-180 days).

Adult↗
PubMed2000

Can addressing family relationships improve outcomes in chronic disease? Report of the National Working Group on Family-Based Interventions in Chronic Disease.

The management of patients with chronic disease constitutes the largest single cost to the health care system in the United States. New approaches and methods are needed to reduce preventable complications and to enhance the health and well-being of patients with chronic disease and their families. Interventions that target the family setting in which disease management takes place have emerged as an alternative to traditional strategies that focus only on the individual patient or that consider the family only as a peripheral source of positive or negative social support. In this approach, the educational, relational, and personal needs of all family members are emphasized. Data reviewed by the National Working Group on Family-Based Interventions in Chronic Disease identified potential mechanisms by which the relational context of the family affects disease management and how characteristics of family relationships serve as risk or protective factors. In this paper we describe the major forms of family-based interventions, review the results of selected clinical trials, and present applications for clinical practice. The data suggest that approaches to the management of chronic disease should be expanded to include the broader relational context in which disease management takes place. Although it adds complexity to clinical intervention, this approach increases clinical flexibility, addresses the important players in disease management, and accounts for a significant number of risk and protective factors that affect outcome.

Adolescent↗
PubMed2003

The Northern Territory preventable chronic disease strategy--promoting an integrated and life course approach to chronic disease in Australia.

The need for an integrated and life course approach to the prevention and control of chronic diseases is increasingly being recognised. This paper describes the development of the Northern Territory Preventable Chronic Disease Strategy (PCDS), the strategic framework and evidence base, the design of implementation and monitoring phases, and early outcomes. The PCDS is premised on the belief that the major chronic diseases, and their common underlying risk factors, are potentially preventable. The structural challenges to larger jurisdictions taking such an integrated approach are undoubtedly larger, but the benefits are potentially great. Continuing with a series of vertical programs aimed at each single noncommunicable disease will not deliver the desired national health outcomes.

Chronic Disease↗
PubMed2003

Early life predictors of chronic disease.

Many chronic diseases may have their seeds early in life. Observations from the Dutch famine have taught us that the intrauterine environment is an important determinant of adult health. Birth weight has been related to cardiovascular disease (CVD), hypertension, diabetes, and cancer. Critical phases for adult obesity development include time periods between conception and adolescence. A life course approach to chronic disease prevention includes the study of maternal diet during pregnancy, intrauterine exposures, postnatal growth, and the adolescent period.

Adolescent↗
PubMedDate not supplied

Descriptions of barriers to self-care by persons with comorbid chronic diseases.

BACKGROUND: Chronic medical conditions often occur in combination, as comorbidities, rather than as isolated conditions. Successful management of chronic conditions depends on adequate self-care. However, little is known about the self-care strategies of patients with comorbid chronic conditions. OBJECTIVE: Our objective was to identify perceived barriers to self-care among patients with comorbid chronic diseases. METHODS: We conducted semistructured personal interviews with 16 adults from 4 urban family practices in the CaReNet practice-based research network who self-reported the presence of 2 or more common chronic medical conditions. Using a free-listing technique, participants were asked, "Please list everything you can think of that affects your ability to care for your medical conditions." Responses were analyzed for potential barriers to self-care. RESULTS: Participants' responses revealed barriers to self-care, including physical limitations, lack of knowledge, financial constraints, logistics of obtaining care, a need for social and emotional support, aggravation of one condition by symptoms of or treatment of another, multiple problems with medications, and overwhelming effects of dominant individual conditions. Many of these barriers were directly related to having comorbidities. CONCLUSIONS: Persons with comorbid chronic diseases experience a wide range of barriers to self-care, including several that are specifically related to having multiple medical conditions. Self-management interventions may need to address interactions between chronic conditions as well as skills necessary to care for individual diseases.

Adult↗
PubMedDate not supplied

Relationship between acute and chronic disease epidemiology.

Epidemiology is the study of epidemics. The primary goal of epidemiological studies should be the identification of the determinants of disease in order to decrease morbidity and mortality. Epidemiological studies evolve through descriptive, analytical, and experimental approaches. The traditional infectious disease epidemiology studies were primarily concerned with identification of an agent, incubation period, mode of transmission, population at risk, and methods of disease control. Chronic disease epidemiology has tended to emphasize a more complex interaction of independent and dependent disease variables that resulted in a greater need for statistical methodology. There has been relatively little interest in chronic disease epidemiology either in modes of disease transmission or in incubation periods. Chronic disease epidemiology has also focused more on analytical epidemiology than on experimental, clinical trials. Many chronic diseases are probably caused by living organisms such as viruses. The fundamental difference in methodology may relate to length of incubation period. Chronic disease epidemiology should probably build more on successful methods of infectious disease epidemiology, especially modes of disease transmission, host susceptibility, incubation periods, and clinical trials. The concept of multifactorial etiology of many chronic diseases may be a measure of our ignorance of causality rather than a biological principle.

Acute Disease↗
PubMed2000

Direct medical costs of chronic obstructive pulmonary disease: chronic bronchitis and emphysema.

In this study we aimed to estimate direct medical costs of Chronic Obstructive Pulmonary Disease (COPD) by disease type; chronic bronchitis and emphysema. This study estimates direct costs in 1996 dollars using a prevalence approach and both aggregate and microcosting. A societal perspective is taken using prevalence, and multiple national, state and local data sources are used to estimate health-care utilization and costs. Chronic bronchitis and emphysema together account for $14.5 billion in annual direct costs. Inpatient costs are greater than outpatient and emergency costs ($8.3 vs. $7.8 billion) and hospital and medication costs account for most resources spent. The high prevalence of chronic bronchitis accounts for its larger total costs ($11.7 billion) compared with emphysema ($2.8 billion). Emphysema, which is more severe, has higher costs per prevalent case ($1341 vs. $816). Hospital stays account for the highest costs, $6.0 billion for chronic bronchitis and $1.9 billion for emphysema. The hospitalization rate, length of stay and average cost per prevalent case are higher for emphysema than for chronic bronchitis. Medication costs are the second highest cost category ($4.4 billion for chronic bronchitis, $0.693 billion for emphysema). The high hospitalization and low home care costs (0.2% of total) suggest underuse of home care and room to shift from acute to preventive care. More attention to healthcare management of chronic bronchitis and emphysema is suggested, and improving inhaler and anti-smoking compliance might be important targets.

Ambulatory Care↗
PubMed1995

Mitral valve prolapse in a case of Marfan syndrome with congenital cardiac disease, chronic obstructive pulmonary disease and schizophrenia.

Mitral valve prolapse (MVP) is a common pathological finding in several inherited connective-tissue diseases among which the Marfan syndrome. In the literature several cases of Marfan syndrome characterized by schizophrenia, chronic obstructive pulmonary disease and severe mitral regurgitation due to a MVP have been reported. Our case of MVP was observed in a patient with Marfan syndrome with its characteristic musculoskeletal disorders associated with congenital cardiac disease, severe chronic obstructive pulmonary disease and schizophrenia. According to the latest genetic studies, Marfan syndrome seems to result from genetic mutations in an extracellular matrix glycoprotein, fibrillin. Authors believe that MVP represents only one of several pathological alterations which may be seen in the Marfan syndrome, as expression of a more generalized genetic disorder.

Adult↗
PubMed2006

[Chronic disease management].

Chronic disease management by primary care physician is one of the outstanding challenges in family medicine. Regular checking of possible interactions between different diagnoses and treatments is of great opportunity. Optimal communication and cooperation between doctors in hospital and primary care is a continuous commitment.

Aged, 80 and over↗
PubMed1988

Airway responsiveness to inhaled histamine in chronic obstructive airways disease. Chronic bronchitis vs emphysema.

Airway responsiveness to inhaled histamine was examined in two groups of carefully selected patients with nonasthmatic chronic obstructive airways disease (COAD). Twelve patients with chronic bronchitis and airflow obstruction but little emphysema and 13 with predominantly emphysema and airflow obstruction but little bronchitis were selected based on history, chest roentgenogram, and diffusing capacity for carbon monoxide (Dsb). Emphysema patients had less cough, less sputum, less chronic bronchitis, lower Dsb, and more radiographic evidence of vascular deficiency. There was no difference in anthropometric features, smoking history, atopic skin sensitivity, hemoglobin, blood eosinophilia, PaO2, PaCO2, ECG, lung volumes, or expiratory flow rates. The two groups had similar airway responsiveness to inhaled histamine; the geometric mean provocation concentrations producing a 20 percent FEV1 fall (PC20) was 0.56 mg/ml for the bronchitis patients and 0.28 mg/ml for the emphysema patients (p greater than 0.20). Regression of log histamine PC20 vs percent predicted FEV1 showed a high correlation in both groups (r = 0.73, p less than 0.01 in bronchitis and r = 0.79, p less than 0.001 in emphysema). The regression lines were almost identical. These data suggest that in COAD bronchial responsiveness to inhaled histamine is mainly due to the altered airway geometry, and that there is no difference in histamine responsiveness between patients with emphysematous COAD and nonemphysematous COAD with chronic bronchitis.

Aged↗
PubMedDate not supplied

Evaluation of the Centers for Disease Control and Prevention's chronic disease state-based epidemiology for public health program support (STEPPS) program.

To identify effective strategies for improving epidemiology capacity in state chronic disease programs, staff epidemiologists and program directors from 25 states were interviewed using a structured questionnaire by phone or in person. Respondents reported three chief barriers to chronic disease epidemiology capacity: lack of institutional commitment and support for chronic disease epidemiology; lack of professional opportunities to engage with peers, colleagues, and scientists; and lack of trained epidemiology staff and resources to support chronic disease functions and activities. Epidemiology capacity in states would be improved by expanding the role and scope of staff placement programs; assisting states in establishing formal collaborations with academic institutions; and providing technical assistance to staff currently employed in states through training, consultation, and networking.

Centers for Disease Control and Prevention, U.S.↗