Managing Chronic Disease in a Primary Care Setting

Abstract

Chronic diseases are becoming prevalent in the USA due to the aging population and lifestyle changes. The burden of managing these illnesses is put on the health care system where the government is trying to invest in health care facilities and streamline medical insurance services. The demand for nursing services and the general care for patients with chronic diseases are also presenting a challenge to stakeholders of health care service provision. As a result, there has been a focus on the use of evidence-based plan of care for managing chronic diseases as a means to containing the situation and improve the quality of services that patients receive. Advanced practice nurses play a crucial role in promoting the health care, enforcing policies and requirements, ensuring proper management of symptoms, and involving the community in tackling cases of chronic illnesses. The purpose of the current paper is to provide a discussion of different issues in chronic diseases management in a primary care setting.

Keywords: chronic disease, diabetes, community education, evidenced-based plan, advanced practice nurse

Managing chronic illnesses in a primary care setting is one of the central focuses of governments and health care stakeholders in communities owing to the high prevalence of such diseases in the recent past. Health care stakeholders allocate considerable resources in terms of personnel and finances to handle the increasing cases of chronic diseases in different communities. As a result, chronic diseases are the basis of formation of policies and procedures as well as innovations in the health care. One of these innovations is the use of evidence-based plans to reduce the cost burden that patients and families face when it comes to dealing with chronic diseases. The purpose is to deliver efficiency in terms of resources required to managing any chronic illness in a primary care setting. Advanced practice nurses also play an important role in caring for patients through health promotion practices, management of medication practices, and management of patients’ symptoms. The aim of the current paper is to discuss the issues in the management of chronic diseases in a primary care setting.

The Impact of Chronic Disease on Health Care

Chronic diseases constitute a leading cause of illnesses in America representing over 90 % of all deaths in the country (Salzman et al., 2012). The aging population has meant that so many old people are suffering from chronic diseases. The latter include a high blood pressure, heart diseases, and diabetes. Hence, they become a huge burden on the overall health care practices in the country. The existence of a wide range of chronic diseases means that so many people are exposed to risk factors and, therefore, their health status is likely to be determined by these risk factors. The health care system is forced to develop plans to care for people with chronic diseases besides training enough nurses to provide a necessary support. The government, on the other hand, invests in research programs to understand how different chronic diseases affect people and the best ways to help them with medication. The classification of chronic illnesses into the chronic obstructive pulmonary disease, cardiovascular diseases, cancers, and diabetes means that a health care system can focus on one particular area and provide efficient services to the people who need help.

Due to the social and economic impact of chronic diseases on a family setting, tackling these illnesses present the biggest challenge for the health care system in America. The need for medical insurance and other social amenities targeting older people have increased the overall budget for medication and treatment of individuals with chronic diseases. The government has enacted several legislations including the controversial Affordable Care Act, commonly known as the Obamacare, to meet health care needs of many American citizens who cannot afford treatment whenever they are diagnosed with chronic diseases (Scaffa & Reitz, 2014). Chronic diseases are the cause of personal (i.e. patients must plan with their family members how to handle their illnesses) and community costs spending (i.e. the health care system must train enough nurses and professionals who are well prepared to deal with an upsurge in cases of chronic diseases).

How Evidence-based Plans of Care can reduce the Health Care Burdens placed on Americans

Evidence-based care is premised on the quality of health care services that patients get in primary care setting. The aim of evidenced care practice is to deliver qualitative and efficient services that help patients to alleviate their suffering and improve the quality of their life. With the increasing cases of these illnesses, Americans are struggling with the burden of meeting the costs of medication and health care treatment when they suffer from such diseases like diabetes (Scaffa & Reitz, 2014). Integrating evidence-based plan of care for managing chronic diseases allows assessment of evidence not just to lower the cost but also to prevent the chronic diseases from occurring in the first place. The interventions are targeted at most vulnerable population groups and risk population. Evidence-based plan of care is established to improve the impact of health care systems, policy implementation, educational programs, and also environmental characteristics that can help to lower cases of chronic diseases (Goroll & Mulley, 2014). The health care systems (including advanced care nurses, clinicians, and physicians as well as workplaces, schools, and the entire community) are brought on board to help with controlling and managing incidences of chronic diseases.

One of the important characteristics of the evidence-based plan of care is the regular use of recommendations from expert authorities on how to handle chronic diseases. In this way, medical officers and family members involved can select the best intervention approaches that are not only cheap but also effective in improving the quality of patient’s life. Experts’ recommendations could be useful for meeting specific patients’ needs including priority areas, cost effectiveness, preventable burdens, and clinical preventive services (Scaffa & Reitz, 2014). Using evidence-based plan of care to handle chronic diseases also allows the concerned parties to develop nationally coordinated efforts that help in achieving a high level of control. These individuals carry out immunization coverage and improve the impact of public health programs targeting people at risk of developing a chronic disease. They are families, health care systems, and the government. The most common factors of developing chronic diseases are smoking and poor lifestyle. Evidence-based plan of care ensures that such conditions are handled effectively through national and state efforts. Such practices are considered as fundamental steps in achieving evidence-based cancer control measures. It means that since the number of people who smoke cigarettes reduces, the health care system benefits in lowered cases of illnesses related to smoking (Goroll & Mulley, 2014).

Cost Effectiveness Achieved by the Use of Evidence-based Plans of Care

The main purpose of integrating evidence-based plans of care is to lower the cost of providing treatment and care for patients with chronic diseases. These programs ensure that the focus is not just on the illnesses but also factors that could cause and alleviate the prevalence. Therefore, the initial investment in tackling the costs of chronic diseases is handling the risk factors as the key to ensuring profitability in the care for patients with chronic illnesses. The first step is reducing the number of people reporting cases of chronic diseases (Stellefson et al., 2013). This step ensures that a small number of resources and personnel in the health care are focused on helping to people suffering from chronic diseases. The second step is choosing the best ways to deliver effective services to patients by availing the medication, facilitating educational programs, and involving families and communities in caring for patients with chronic diseases. Another way in which evidence-based plans of care helps in achieving cost effectiveness is through the involvement of family members who provide care for patients. Through educational programs, family members can be trained to participate in providing care for patients. Instead of going to a nursing home or homes for the elderly or even being admitted for a long duration in hospitals, patients receive care at home from their family members and assistance of health care officers such as advanced nurses. Therefore, since they use facilities in their homes, the cost of care becomes lowered.

The Role of an Advanced Practice Nurse in Caring for Patients with Chronic Illness

An advanced practice nurse (APN) is a key player in providing services to patients with chronic illnesses. APN is a leader in developing and enforcing educational programs aimed at promoting healthy living. A nurse acts as an educator besides overseeing the implementation of policies and recommendations from authorized bodies (Salzman et al., 2012). Furthermore, APN is responsible for educating patients, family members, and communities on how to administer medication and manage how patients take their medication. For instance, in the case of diabetes, where patients are put on a lifelong medication, APN is responsible for educating patients. They are educated on the importance of adhering to the instructions from the physicians and ensure that they are following doctors’ recommendations. APN is also a major partner in observing symptoms of different chronic diseases and help patients to manage their illnesses. By educating members of the community on symptoms of chronic diseases, they can report as soon as they observe any of these symptoms to the concerned authority and get assistance (Stellefson et al., 2013). The role of APN’s is important because they act as an intermediary between patients and health care systems as they have closer interactions with patients in their communities and families.

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Managing chronic illnesses in primary care setting requires the collaboration of different stakeholders including patients, communities, and health care professionals. The use of evidence-based practice is essential to achieving better quality service and cost effectiveness in the process of caring for patients in their setting. APN plays a key role as a health promoter, an educator, and a physician with knowledge of symptoms and how to manage chronic illnesses.