Chronic Illness

Chronic illnesses are prolonged, do not resolve spontaneously, and are rarely completely cured. The most common are cardiovascular diseases (hypertension, coronary artery disease, stroke and heart failure), the arthritides, asthma and chronic obstructive pulmonary disease, diabetes and epilepsy. There is increasing evidence that mental illnesses such as depression are best understood as chronic health problems. HIV/AIDS has become a chronic condition in those countries where effective medication is available.

As life expectancy increases, so does the likelihood that people will become susceptible to chronic illness. Between 1996 and 2020, the population aged over 65 is projected to increase by about 82% globally (110% in less developed countries, and 40% in more developed countries). Chronic disease is now the main reason why people seek health care in the developed world. Because of the difficulty and duration of treatment, the costs of chronic health conditions are enormous: in the USA it now consumes 70% of health care spending [Holman H., Lorig K. Patients as partners in managing chronic disease. BMJ 2000, 320.526-7].

Awareness is increasing that similar strategies can be effective in treating many different conditions. These are likely to involve the proactive identification of relevant populations; to provide support for the relationship between people living with long term health conditions and health and social care professionals; to develop evidence-based care guidelines which emphasise the prevention of exacerbation and complications; and promote empowerment strategies for people living with chronic illness, such as self-management and education. They also require continuous evaluation of clinical, humanistic and economic outcomes.