Are disease management programmes (DMPs) effective in improving quality of care for people with chronic conditions?

Summary

The issue

Chronic diseases account for most of the burden of disease in the European Region. Although there are effective interventions for the management of various chronic conditions, there are also wide practice variations in the delivery of care. DMPs are one of the measures intended to address this situation. DMPs organize care in multidisciplinary, multicomponent programmes, in a proactive approach focusing on the whole course of a chronic disease, using evidence-based standards of care.

Findings

Most of the evaluated DMPs for chronic conditions have been shown to improve the management and control of the disease. There is a wide body of evidence on this for diabetes, depression, chronic heart failure and cardiovascular diseases.

There is evidence that DMPs improve providers’ adherence to evidence-based standards of care.

There is no evidence about which components of a DMP are most important for improving quality of care.

There is no evidence of a direct link between DMPs and significant reductions in mortality or of improvements in quality of life.

There is no evidence on DMPs’ cost–effectiveness.

Policy considerations

There is a need to improve the quality of care for people with chronic diseases. DMPs will achieve this goal for chronic conditions such as diabetes, depression, chronic heart failure and cardiovascular diseases. Although there is a clear link between improved management of chronic conditions and better health outcomes, there is no scientific evidence that specific DMPs improve the survival rate or quality of life. However, the absence of evidence does not mean absence of effect; it means it has not been studied.

Investments in DMPs may be costly. Therefore it is important to study the cost–effectiveness of any DMP before it is introduced on a large-scale.