Diabetes as a case study of chronic disease management with a personalized approach: the role of a structured feedback loop.
As non-communicable or chronic diseases are a growing threat to human health and economic growth, political stakeholders are aiming to identify options for improved response to the challenges of prevention and management of non-communicable diseases. This paper is intended to contribute ideas on personalized chronic disease management which are based on experience with one major chronic disease, namely diabetes mellitus. Diabetes provides a pertinent case of chronic disease management with a particular focus on patient self-management. Despite advances in diabetes therapy, many people with diabetes still fail to achieve treatment targets thus remaining at risk of complications. Personalizing the management of diabetes according to the patient's individual profile can help in improving therapy adherence and treatment outcomes. This paper suggests using a six-step cycle for personalized diabetes (self-)management and collaborative use of structured blood glucose data. E-health solutions can be used to improve process efficiencies and allow remote access. Decision support tools and algorithms can help doctors in making therapeutic decisions based on individual patient profiles. Available evidence about the effectiveness of the cycle's constituting elements justifies expectations that the diabetes management cycle as a whole can generate medical and economic benefit.
Insititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Hospital Clínic Barcelona, Barcelona, Spain. aceriell@clinic.ub.es
Antonio
A
Ceriello
László
L
Barkai
Jens Sandahl
JS
Christiansen
Leszek
L
Czupryniak
Ramon
R
Gomis
Kari
K
Harno
Bernhard
B
Kulzer
Johnny
J
Ludvigsson
Zuzana
Z
Némethyová
David
D
Owens
Oliver
O
Schnell
Tsvetalina
T
Tankova
Marja-Riitta
MR
Taskinen
Bruno
B
Vergès
Raimund
R
Weitgasser
Johan
J
Wens
D001786:Blood Glucose; D019090:Case Management / Q000458:organization & administration*; D002908:Chronic Disease / Q000628:therapy*; D003661:Decision Support Techniques; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000592:standards; D011787:Quality of Health Care; D011788:Quality of Life; D012648:Self Care
D001786:Blood Glucose