Chronic Disease Management

Note: In 2011, AOTA identified chronic disease management as an emerging niche in occupational therapy. Since then it has become more mainstream, so newer content appears elsewhere on this site. This page has been retained for historical information. Learn more about the 2011 Emerging Niche series here.

Why emerging? Chronic conditions account for 66% of the nation's health care budget, and more than a quarter of all Americans have multiple chronic conditions.¹ As the number of older Americans increases, those figures are expected to rise even more. Managing chronic diseases is one way to cut costs and improve health, which is why the health care reform legislation—the Patient Protection and Affordable Care Act²—included a new fund to assist states and communities to prevent illness and promote health.³

Get Involved! Salvador L. Bondoc, OTD, OTR/L, CHT, has worked mainly in physical rehabilitation since beginning his career in 1995. His clients have a mix of acute injuries and chronic conditions, and he believes that when working with people with chronic conditions occupational therapy practitioners must think of managing function, not just remediating problems. "The signs and symptoms will not go away," says Bondoc. "We must think of helping clients functionally manage their symptoms while promoting occupational engagement."

Practitioners who want to expand into this area need to emphasize what occupational therapy is good at—promoting living life to its fullest, says Bondoc. He suggests using principles of positive psychology, emphasizing what clients are capable of doing now, and collaborating with clients to discover ways to make engaging in occupations easier, less painful, less fatiguing, and more enjoyable. Within chronic disease management, practitioners can excel at life care planning for the aging population, community-based care, being a point person in discharge teams for helping clients with transitions, and symptom management.

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Resources:

• AOTA Fact Sheets:
  • Occupational Therapy's Role in Health Promotion by Jyothi Gupta, PhD, OTR/L, OT(C); Barbara E. Chandler, PhD, OTR/L, FAOTA; and Pam Toto, MS, OTR/L, BCG, FAOTA
  • The Role of Occupational Therapy in Chronic Disease Management Chronic Disease Fact Sheet, by Salvador Bondoc, OTD, OTR/L, CHT, and Carol Siebert, MS, OTR/L, FAOTA
  • Occupational Therapy's Role in Diabetes Management by Debra A. Sokol-McKay, MS, OTR/L, CDE, SCLV, CVRT, CLVT
  • Occupational Therapy's Role in Managing Arthritis by Lenore Frost, PhD, OTR/L, CHT, and Fran Harmeyer, OTR/L
• OT Practice Articles:
  • Fatigue Management in Chronic Illness, by Kara Stout, OTD, OTR/L, and Marcia Finlayson, PhD, OT(C), OTR/L, in January 24, 2011, OT Practice.
  • Practicing Who I Am: Occupational Therapy, Crohn's Disease, and Self-Management, by Carol Seibert, MS, OTR/L, FAOTA, in September 28, 2009, OT Practice.

References:
1. Silva, C. (2011, January 10). Multiple chronic conditions target of new HHS strategy. Retrieved March 17, 2011, from http://www.amednews.com/article/20110110/government/301109957/6/
2. Patient Protection and Affordable Care Act. Pub. L. 111-148.
3.  U.S. Department of Health & Human Services. (2010, June 18). Sebelius announces new $250 million investment to lay foundation for prevention and public health. Retrieved from http://wayback.archive-it.org/3926/20131018160731/http://www.hhs.gov/news/press/2010pres/06/20100618g.html