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Chronic Disease Self-Management: What is it? How is it Achieved at the Systems Level?

• Dr. Robert Mead, MD, Bellin Health
• Laura Saddler, MPH, CHES, Oregon Public Health Division
• Moderators: Sarah O'Leary, MPH, MA, (Session A), and Diane Manheim, MSW, (Session B), Centers for Disease Control and Prevention

Session Objective

The objectives for this session are to:

• Understand the link between primary care and self-management and its role in improving health outcomes.
• Identify partners that need to be involved in program development and implementation to promote adoption of patient self-management.
• Identify potential barriers to implementation and how to overcome them.
• Identify factors that promote sustainability of self-management at a systems level.
• Identify strategies for integrating self-management across chronic disease care.

Session Summary

Patient self-management of chronic disease is a crucial component of the Chronic Care Model and necessary for improved health outcomes. This session provides two perspectives on disease self-management options for primary and secondary prevention. Presenters discuss experiences integrating self-management strategies across diseases in clinical settings and the community, challenges encountered and lessons learned, and assist participants in developing a plan to increase self-management at the systems level in their state/health care organization.

During the activity, participants work individually and in a small group to identify what is going on in their state/tribal organization on self-management, brainstorm about opportunities and supports needed to increase self- management, identify partners, and plan action steps.

Session Materials

• Chronic Disease Self-Management: Focus on Community Systems (PPT, 10MB)
• Planned Care for Chronic Disease (PPT, 1.2MB)

Resources/References/Web Sites/Tools

• Chronic Care Model
  http://www.improvingchroniccare.org/index.php?p=The_Chronic_Care_Model&s=2
• Chronic Illness Management: What Is the Role of Primary Care?
  Arlyss Anderson Rothman, PhD, MHS, and Edward H. Wagner, MD, MPH