Our healthcare system is failing people with chronic diseases

Media Release, Tuesday 4 October 2005

A major review of public health policy and management strategies for the treatment of chronic illnesses, such as arthritis, cardiovascular disease, cancer and diabetes, in Victoria is being led by Melbourne researchers.

From the University of Melbourne's AFV Centre for Rheumatic Diseases, Dr Richard Osborne says the acute healthcare system (i.e. hospitals) fails to adequately deal with people with ongoing chronic conditions – the primary cause of death in the developed world.

Dr Osborne says the care of patients with chronic disease is one of the most urgent medical challenges of Australian and other Western healthcare systems. Chronic illness accounts for most of the demand, expense, and investments in scientific discovery.

Alongside this, “Most people with a chronic disease spend 99 per cent of their time by themselves or with their families and carers and only one per cent in interaction with healthcare professionals,” he says.

“This is because the current healthcare system is primarily structured for rapid responses to acute diseases, not for the long-term, multi-factorial response needed to support people with chronic disease.

“This leaves chronic disease sufferers needing to use their own resources to help manage their health problems outside the health care system.”

An American designed technique called the Stanford Chronic Disease Self-Management Program has been offered in Australia for the past 20 years to help chronic disease sufferers manage their illnesses and improve interactions between them and healthcare professionals, while reducing healthcare costs.

“There is now a worldwide movement happening with patient education and self management because it appears to be a win-win situation. Patients get empowered, doctors have more informed patients, and it has the potential to reduce healthcare costs. The UK Government has taken this on in a big way in the last couple of years – they have put over 30,000 patients through the program as part of a healthcare reform,” Dr Osborne says.

However, he warns that despite widespread use, it is unknown how effective the Stanford or other self-management models have been in an Australian setting. Another challenge is integration into current Australian medical practice.

Dr Osborne says it will be critical to the success of this program that family doctors especially are on board. They have to believe that the program is of high quality and designed to help them manage patients, improve coping and compliance and supporting improvements to lifestyle, rather than telling patients to go off and do their own thing.

“One of the critical outcomes of self-management programs is that participants get a chance to get a new perspective on their health – in a group setting they can get to see they are better or worse off than they thought they were and then undertake lifestyle and attitude changes. This can be a big change for some people – but sometimes a life saver in the end.

“This is not the “be all and end all” of patient care, but for some people it seems to help take them from a life of misery and disempowerment to a life of empowerment, effective life skills and hope,” he says.

Dr Osborne and colleagues have commenced a major international review of self-management techniques and programs both from a traditional biomedical perspective and from an innovative public health perspective.

The researchers hope to produce a set of prioritised recommendations and national mapping of self-management resources and quality to enable clinicians and governments to make the best resources available to chronic disease sufferers in Australia.

More information about this article:

Elaine Mulcahy
Media Promotions Officer
emulcahy@unimelb.edu.au
Tel: 61 3 8344 0181
Mob: 0421 641 506

Richard Osborne
Department of Medicine
03 8344 3144
04 3833 0229
richardo@unimelb.edu.au