Chronic Disease

Question 1

Most chronic diseases are caused by a short list of risk behaviors. What are the main four?

Answer 1

1. Tobacco use and exposure to secondhand smoke
2. Excessive alcohol use
3. Poor nutrition
4. Lack of physical activity

Question 2

How many adults in the U.S. have a chronic disease?

Answer 2

1 in 2 (50%)

Question 3

What are some of the definitions/characteristics of chronic disease?

Answer 3

• Lasting 3+ months
• Generally cannot be cured
• Often non-communicable
• Additive effects over time
• Affect patient’s activities of daily living

Question 4

Multi-morbidity risks strongest correlated with chronic disease include…

Answer 4

• Age
• Lower level of education
• Public health insurance

Question 5

Why has there been a rise in chronic disease prevalence?

Answer 5

• Aging population
• Improved life expectancy
• Better disease detection
• More aggressive therapy
• Increased population prevalence of many diseases due to lifestyle choices (ex: Diabetes has increased in prevalence over last 20 years)
• Cardiovascular events
• Obesity

Question 6

Chronic disease has behavioral ______ and behavioral _______.

Answer 6

etiologies; consequences

Question 7

What is one of the most common complications of chronic disease?

Answer 7

Depression (1/3 of patients with chronic illness have depression)

Question 8

Insufficient sleep has been linked to which chronic diseases?

Answer 8

• Type II Diabetes
• Obesity
• Cardiovascular disease

Question 9

When sleep is a concern for someone with a chronic disease, what is the first thing a doctor should think of?

Answer 9

Depression! Always assess for depression and take a detailed history of the sleep pattern.

Question 10

What are the psychological stages of chronic illness?

Answer 10

DABDA…

• Denial
• Anger
• Bargaining
• Depression
• Acceptance

Question 11

What are things that a strong physician-patient relationship can impact?

Answer 11

• Disease outcome
• Physiology
• Overall function
• Patient’s perception of well-being

Question 12

What is the quality that most significant influences patient outcomes?

Answer 12

Empathy!

Question 13

What are some of the physician barriers to communication?

Answer 13

• Burnout/lack of empathy
• Inattentiveness
• Jargon
• Oversimplification
• Depersonalization
• Lack of feedback
• Stereotypes of patients

Question 14

What is the aim of Chronic Care Management (CCM)?

Answer 14

To transform daily care for patients with chronic illness from acute/reactive to planned, proactive, and population-based.

Question 15

What percentage of the nation’s health care costs are spent on chronic disease?

Answer 15

Over 86%

Question 16

What are the main behavioral consequences of having a chronic disease?

Answer 16

• Depression
• Anxiety
• Sleep disturbance

Question 17

What are the common behavioral etiologies of chronic disease?

Answer 17

• Tobacco
• Excessive alcohol use
• Poor nutrition
• Lack of physical activity
• Lack of time
• Poor sleep
• Income for healthy foods
• Genetics

Question 18

What is a hallmark of physician burnout?

Answer 18

Decreased empathy

Question 19

What is the new model for chronic illness management that has been shown to improve patient-oriented outcomes in many chronic diseases?

Answer 19

Interprofessional CCMs