Model-based combination of treatments for the management of chronic comorbid patients

Abstract

The prevalence of chronic diseases is growing year after year. This implies that health care systems must deal with an increasing number of patients with several simultaneous pathologies (i.e., comorbid patients), which involves interventions combining primary, specialist, and hospital cares. Clinical practice guidelines provide evidence-based information on these interventions, but only on individual pathologies. This sets up the urgent need of developing ways of merging multiple single-disease interventions to provide professional assistance to comorbid patients. Here, we propose an integrated care model formalizing the treatment of chronic comorbid patients across primary, specialist and hospital cares. The model establishes the baseline of a divide-and-conquer approach to the complex task of multiple therapy combination that was tested on the comorbidity of hypertension and chronic heart failure. © 2013 Springer-Verlag.