rs assert that the time required to fully adhere to current guidelines is a fundamental obstacle to the delivery of appropriate and recommended chronic disease care, and they caution guideline developers to carefully consider the time required to follow recommendations, noting that while guidelines may be reasonable when considered one by one, they are impossibly burdensome in the aggregate. They suggest that recommendations be written collaboratively to include diseases that are highly correlated in the same guideline. They also suggest that group visits and patient education by print, video and the Internet can complement care by the clinician. Lastly, they call for a team approach to care wherein physician assistants, nurse practitioners and health educations assume some of the time-consuming tasks of patient education and follow-up.
Is There Time for Management of Patients with Chronic Diseases in Primary Care?
By Truls Ostbye, M.D., Ph.D., et al

PATIENTS WITH MORE THAN ONE ILLNESS ARE THE RULE RATHER THAN THE EXCEPTION IN FAMILY PRACTICE
Most primary care patients have more than one chronic condition, according to a study of 980 adult patients seen in family practice. Researchers found that nine out of ten patients studied had more than one chronic condition, and approximately half of the patients had five or more. The authors assert that such a high prevalence of multiple chronic conditions calls into question the very organization of our health services. They point out that interventions that suit patients with a single disease may not be appropriate for patients with many comorbid conditions, and they suggest that practice guidelines should address special recommendations for patients with multiple conditions. Likewise, clinical trials of drugs would improve their external validity by including such patients. They assert that new health care models that will meet the needs of these patients must emphasize the importanc
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Contact: Angela Lower
alower@hotmail.com
913-906-6253
American Academy of Family Physicians
31-May-2005

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