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Living with Not One, but Six Chronic Conditions

Deputy Assistant Secretary for Health, Dr. Anand K. Parekh

As I approached the exam room, I looked at the clinic schedule, which noted the next patient’s reason for visiting as “DM” (medical shorthand for diabetes). Upon entering the room and speaking to Louise, I realized that the 58-year-old woman not only had diabetes, she also had high blood pressure, hypothyroidism, high cholesterol, asthma, and arthritis (not to mention a history of depression). She brought with her a plastic bag of medications – eight in all – for which she needed multiple refills. Fortunately for Louise, she didn’t require insulin as of yet; nor did she require the care of specialists. She watched her diet (though too much salt was still a problem), tried to be physically active (though her knees always ached), and made sure she took her medications on time.

Under the circumstances, Louise is in pretty good shape. But along with the 75 million other Americans who have multiple chronic conditions, she is at high risk for hospitalizations, adverse drug events, and poor quality of life, not to mention high health care costs.

Taking care of patients like Louise is increasingly common for physicians like myself. And as gratifying as it is to care for these patients, one of the reasons I was drawn into public service was to help change the system to help this vulnerable population.

At the Department of Health and Human Services, I lead an initiative to improve the health status and quality of life of individuals with multiple chronic conditions. We are supporting self-care management programs to help individuals with chronic diseases to live independently. We are also reimbursing health care providers in new ways to promote care coordination and management for individuals with multiple health conditions. And we’re investing in new research to help identify which treatments and strategies work (and which don’t) for people with different combinations of conditions.

What should you do if you have multiple chronic conditions?  Here are four tips that may be helpful:

  1. Identify a quarterback. It’s critical to have a provider, usually a primary care physician, who is responsible for managing all your conditions and medications. They don’t have to be the expert in all areas, but they should know everything that is going on with respect to your care.
  2.  Make healthy choices. It’s estimated that 80% of heart disease and stroke, 80% of type 2 diabetes, and 40% of cancers could be eliminated if Americans were able to do three things: stop smoking, eat a healthy diet, and get regular exercise. These same behaviors may also prevent exacerbations of existing chronic conditions.
  3.  Take advantage of community resources. There are many resources in communities that support health promotion and disease prevention. Find a trusted organization, such as a local YMCA or Area Agency on Aging, to see if they have programs that may be able to help you.
  4. Adhere to medications. People with multiple chronic conditions usually take multiple medications. Develop a reminder system to make sure that you’re taking the right medications at the right time.

With an aging population and advances in modern medicine, there will be more and more people living with multiple chronic conditions in the future. With optimal care coordination, it will be possible to enjoy a high quality of life. Taking these four steps can help individuals with multiple chronic conditions, like Louise, to optimize their health status and quality of life today and in the future.

(Courtesy of WebMD)