Disease Management Programs in Cardiology: Extending the Success in Failure
The tremendous success of cardiology has led to symptomatic cardiovascular disease developing later in life and the prolongation of survival when clinically overt disease does develop.1-4 As a result, even though age-adjusted incidence of cardiovascular problems may be falling, the prevalence of many is increasing because of lengthening survival.1-4 Even cardiac conditions that were once relatively acute in onset and often rapidly fatal have now become chronic diseases.5,6 Our clinics and wards in the more developed regions of the world are full of increasingly elderly patients with multiple chronic cardiovascular and other problems, often treated with an even larger number of pharmacological therapies.7 In parallel with these staggering demographic changes, cardiology and medicine in general has changed. Cardiology has become more and more technology driven and the delivery of medical care has become increasingly disjointed. Doctors feel they have less time to offer their patients and patients are often bewildered by the variety of specialisms involved in their care and exhausted by the many different clinics they (and often their spouses as well) are asked to attend. Treatment adherence is a challenge for many. As a result, ever more vulnerable and complex patients may not receive the comprehensive, individually optimised, evidence-based, care that can make a difference for them, health care systems and societies. The apparently ever growing numbers of emergency department visits, hospital admissions and re-admissions are the result of the interaction between these and other factors.
- Received April 12, 2016.
- Accepted April 12, 2016.