Chronic Illness Management
Research overview
What do diabetes, back pain, depression, and heart disease have in common? They're among a host of chronic health problems and disabilities that have traditionally received too little attention from health care systems — until serious complications develop. Modern medicine tends to focus on detecting and treating acute problems, leaving fewer resources for the needs of patients with chronic illnesses, which may be less urgent but are equally important.
Our population is aging rapidly, and people with chronic conditions are living longer. Chronic conditions now affect more than 145 million Americans. About half of Americans over 65 — our nation’s fastest-growing segment — have at least 2 chronic conditions. As our need for improved chronic care grows, health care delivery systems are trying to correct the many deficiencies in current management of chronic diseases.
For over 2 decades, KPWHRI scientists have been developing, implementing, and promoting better models of care for chronic illness. Much of this work is led by the institute's Center for Accelerating Care Transformation (ACT Center), which is widely recognized for its refinement and dissemination of the Chronic Care Model. The ACT Center continues to work with providers nationwide to develop strategies and tools for health care systems seeking to improve chronic illness care.
Such resources are then shared globally through active engagement with international organizations developing guidance and care recommendations. Providers worldwide continue to adapt materials such as the ACT Center’s Patient Assessment of Chronic Illness Care and Patient-Centered Medical Home Assessment surveys.
Recent publications on Chronic Illness Management
Bombardier CH, Ehde DM, Gibbons LE, Wadhwani R, Sullivan MD, Rosenberg DE, Kraft GH. Telephone-based physical activity counseling for major depression in people with multiple sclerosis. J Consult Clin Psychol. 2013; 81(1):89-99. PubMed
Tsuang D, Leverenz JB, Lopez OL, Hamilton RL, Bennett DA, Schneider JA, Buchman AS, Larson EB, Crane PK, Kaye JA, Kramer P, Woltjer R, Trojanowski JQ, Weintraub D, Chen-Plotkin AS, Irwin DJ, Rick J, Schellenberg GD, Watson GS, Kukull W, Nelson PT, Jicha GA, Neltner JH, Galasko D, Masliah E, Quinn JF, Chung KA, Yearout D, Mata IF, Wan JY, Edwards KL, Montine TJ, Zabetian CP. APOE ß4 increases risk for dementia in pure synucleinopathies. JAMA Neurol. 2013;70(2):223-8. doi: 10.1001/jamaneurol.2013.600. PubMed
Thacker EL, McKnight B, Psaty BM, Longstreth WT Jr, Dublin S, Jensen PN, Newton KM, Smith NL, Siscovick DS, Heckbert SR. Association of body mass index, diabetes, hypertension, and blood pressure levels with risk of permanent atrial fibrillation. J Gen Intern Med. 2013 Feb;28(2):247-53. doi: 10.1007/s11606-012-2220-4. Epub 2012 Sep 13. PubMed
Davydow DS, Katon WJ, Lin EH, Ciechanowski P, Ludman E, Oliver M, Von Korff M. Depression and risk of hospitalizations for ambulatory care-sensitive conditions in patients with diabetes. J Gen Intern Med. 2013 Jul;28(7):921-9.doi: 10.1007/s11606-013-2336-1. Epub 2013 Jan 17. PubMed
Jensen RA, Sim X, Li X, Cotch MF, Ikram MK, Holliday EG, Eiriksdottir G, Harris TB, Jonasson F, Klein BE, Launer LJ, Smith AV, Boerwinkle E, Cheung N, Hewitt AW, Liew G, Mitchell P, Wang JJ, Attia J, Scott R, Glazer NL, Lumley T, McKnight B, Psaty BM, Taylor K, Hofman A, de Jong PT, Rivadeneira F, Uitterlinden AG, Tay WT, Teo YY, Seielstad M, Liu J, Cheng CY, Saw SM, Aung T, Ganesh SK, O'Donnell CJ, Nalls MA, Wiggins KL, Kuo JZ; Blue Mountains Eye Study GWAS team; CKDGen Consortium, van Duijn CM, Gudnason V, Klein R, Siscovick DS, Rotter JI, Tai ES, Vingerling J, Wong TY. Genome-wide association study of retinopathy in individuals without diabetes. PLoS One. 2013;8(2):e54232. doi: 10.1371/journal.pone.0054232. Epub 2013 Feb 5. PubMed
Researchers in Chronic Illness Management
 Beverly B. Green, MD, MPHSenior Investigator |
 James D. Ralston, MD, MPHSenior Investigator |
 Paula Lozano, MD, MPHSenior Investigator; Director, ACT Center |
 Katie Coleman, MSPHDirector, ACT Center |
 Gregory E. Simon, MD, MPHSenior Investigator |
 Katharine A. Bradley, MD, MPHSenior Investigator |
 Jennifer B. McClure, PhDDirector, Investigative Science |
 Dori E. Rosenberg, PhD, MPHSenior Investigator |
 Ben Balderson, PhDSenior Collaborative Scientist |
 Joseph E. Glass, PhD, MSWAssociate Investigator |
 Yu-Ru Su, PhDAssociate Biostatistics Investigator |
 Chloe Krakauer, PhDCollaborative Biostatistician |
 Mikael Anne Greenwood-Hickman, MPHCollaborative Scientist |
 Laurel Hansell, MA, MPHCollaborative Scientist |
 Claire Allen, MPHManager, Collaborative Science |
 Morgan Justice, MACollaborative Scientist |
Affiliate Researchers in Chronic Illness Management
Laura-Mae Baldwin, MD, MPH
Professor, Department of Family Medicine
University of Washington
Linda LeResche, ScD
Associate Dean for Research, School of Dentistry
Professor, Oral Medicine
University of Washington
Healthy findings blog
What works to meet complex needs in diabetes care?
An ACT Center partnership is helping a nonprofit engage patients and provide comprehensive care.
Research
New numbers could help diagnose and treat a common, complex condition
Researchers gain better understanding of polycystic ovary syndrome's impact in U.S.
New findings
Relieving chronic pain with CBT
Cognitive behavioral therapy with yoga-based movement helps with pain for those on long-term opioids.
news release
NIH awards over $15 million in HEAL grants to KPWHRI
Drs. DeBar, Bradley, and Sherman lead projects in initiative to tackle opioid crisis.
opioid research
Opioids may raise risks for serious infections
In Annals editorial Drs. Sascha Dublin and Michael Von Korff advocate more caution in prescribing these medications
Read it in Healthy Findings.
pain management
Six Building Blocks help small rural clinics to manage opioids better
Led by Dr. Michael Parchman, research team uses new way to support small clinics in reducing opioid use in rural Pacific Northwest.
Recent News
Patients may not be telling their doctors what matters to them most
KPWHRI’s VITAL study discovers six domains that people with chronic illness too rarely discuss with their care providers.
Read about it & watch the video in News and Events.
new frontiers
Do mast cells hold the key to chronic and unexplained disease?
Dr. Jennifer McClure reflects on evidence about mast cells as a key to chronic disease, providing new insights for physicians, researchers, and the public.
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