Meeting the Care Needs of Patients with Multiple Chronic Conditions

Primary care facilities and hospitals have long been aware of the significant burden borne by patients who present with chronic medical conditions. Current estimates suggest that nearly 50% of American adults have at least one chronic medical condition (Ward, Schiller, & Goodman, 2014; Wu & Green, 2000). Patients commonly present to the primary care setting for management of symptoms and functional impairments associated with hypertension, high cholesterol, diabetes, skin conditions, or arthritic conditions. Patients with chronic medical conditions often experience marked changes in overall quality of life, with varying degrees of compromise experienced across work, household, recreational, social, interpersonal, and familial domains of function. These changes in overall quality of life, in conjunction with the stress of diagnosis and the demands of disease management, often result in psychological distress that would be deemed clinically significant and require intervention. Primary care physicians are among the first healthcare providers tasked with managing these chronic medical conditions and the associated physical and psychological compromise. For patients with chronic medical conditions that require extensive intervention by medical providers or involve complex self-management regimens, patient care needs are much more likely to be assessed and managed through any number of general and specialty care clinics.