Wednesday, October 14, 2009

Using the Chronic Care Model to Treat Obesity

Obesity may be viewed as a chronic illness. Therefore, tools used to successfully treat chronic illnesses can be used to treat obesity. An effective tool for treating chronic illness is called the Chronic Care Model. The Chronic Care Model was developed by the MacColl Institute for Healthcare Innovation. The institute is based in Seattle, Washington. The institute developed the model to treat those illnesses that require an ongoing relationship between the ambulatory patient and the health care provider.

The model was developed more than a decade ago. In designing the model, the developers researched literature to uncover methods that could be used to improve the treatment of chronic illnesses. Over time, the model evolved to contain six key elements. These elements are: community resources and policies, the provider’s health care organization, case management, delivery system design, decision support, and self-management.

The first of the six elements is community resources and policies. This means that the health care provider should make use of existing community resources. Further, the provider should work to institutionalize policies that improve care. In making use of community resources, for example, a bariatric center could partner with a gym in the community to provide exercise to patients.

The next item on the list is the provider’s health care organization. Among other things, this item stipulates that the provider’s health care organization should actively support improvements in health care. And the provider’s organization should emphasize the use of quality measures in the application of health care.

Case management, the next list item, is meant to indicate that the provider should work with the patient to enhance the patient’s self-management. Self-management will be discussed below. Case management also entails follow-up to make sure the treatment is working. Case management also includes an effort to help guide the patient through the health care system.

The delivery system design is the next element on the list. It is essential, for example, that the delivery system be designed so that necessary resources be made available to the patient. In fact, implementing the delivery system so that both the provider and the patient have access to resources is important. In the system, evidence based treatment methods should be used. And many of these treatment methods ought to be delivered by non-physician members of the provider team. Because in some cases, it has been found that non-physician members can deliver certain services better than the physician.

Next, we have decision support. Evidence-based guidelines must be part of the health care provider's organization. Established education methods should be employed. And treatment guidelines and clinical information should be shared with the patient.

Last on the list is self-management. Indeed, it has been found that self-management is a necessary part of the Chronic Care Model -- more so than any other element. In self-management, the patient must be viewed as the central player in the ongoing treatment of the chronic illness. And as part of the process, the provider must agree to relinquish some control to the patient.

Since the introduction of the Chronic Care Model, efforts have been made to determine if the model improves health outcomes and is cost effective. Although more work needs to be done to determine the cost effectiveness of the model, published reports appear to indicate that by using the Chronic Care Model, health care organizations can improve the treatment of chronic illness.

Since overweight and obesity may be viewed as a chronic illness, The Chronic Care Model is applicable in the treatment of the illness. It has been shown that for long-term success, a strong ongoing relationship between the individual attempting to lose or control weight and the organization providing the weight loss or weight management service is of utmost importance. And the Chronic Care Model emphasizes this relationship.

Indeed for obesity treatment, weight loss centers should review elements of the Chronic Care Model, and try to implement as many of the model's elements as possible, with an emphasis on self-management.

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Comments:

Anonymous Dental Fairfield said...

Becoming obese is one of my worst nightmare. Self discipline is the key to a healthier lifestyle. your posts are indeed informative by the way! thanks for sharing them.

October 29, 2009 at 11:32 PM  

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