Hugely successful Chronic Disease Management Programme is leading to better patient outcomes – Conway

The Chronic Disease Management Programme has been a huge success story and has led to better outcomes for some patients availing it, according to Fine Gael Senator Martin Conway.

Senator Conway, Fine Gael’s Seanad health spokesperson, said the programme introduced by Fine Gael in 2019 enables patients with chronic diseases to be treated in the community, which is having a positive effect on the health service.

Senator Conway said: “Under the 2019 GP Agreement, the Chronic Disease Management (CDM) Programme began in 2020 and identifies and manages GMS and GP visit card patients at risk or who have specified chronic disease including Diabetes; Asthma; Chronic Obstructive Pulmonary Disease (COPD) hypertension and Cardiovascular disease.

“Women who have been diagnosed with gestational diabetes or pre-eclampsia since January 2023 in the CDM Preventative Programme are also covered under the programme.

“Its goals is to minimize these patients’ symptoms, improve their quality of life, and prevent unnecessary hospitalisations.

“Information provided to me show that at the end of February this year, there were 2,402 GMS GPs signed up to provide the CDM Programme. As of January 1^st, almost 400,000 patients have been registered to the CDM treatment programme, with GPs and practice nurses conducting over two million chronic disease patient reviews from January 2020 to December 2023.

“Patients can now also access services for their conditions from the 53 specialist older persons and chronic disease teams that have been established under the enhanced community care, ECC, programme.

“To recognise the additional workload arising for GP Practices under the Chronic Disease Management Programme, funding was provided for in the GP Agreement (2019) to support improving Practice Nurse capacity.

“The results of this programme have been extremely positive. In March 2023, a report found 91% of patients with chronic disease were not now attending hospital for the ongoing management of their chronic condition, which was now fully managed routinely in primary care.

“This report looked at 186,210 patients treated by GPs for the first two years of the programme.

“Approximately 44% of patients who had hypertension at their first visit no longer did at their third visit, while 42% of diabetic patients who were not achieving treatment targets at their first visit did achieve them by their third visit.

“Of patients who were obese at their first visit, 14% of them had reduced weight and were now not obese at their third visit. 67% of people who had harmful drinking patterns at their first visit no longer did at their third visit.

“Chronic diseases are becoming more common in Ireland, as the population ages and grows. That is why this model of care in the community is so vital. As well as providing better patient outcomes, it reduces pressure on hospitals as patients with specified or multiple conditions can be managed in their communities.

“I would hope that Government investment in general practice continues to grow to the benefit of community care programmes,” Senator Conway concluded.