How can Chronic Disease Management Programmes Operate Across Care Settings and Providers?

There is no correct approach to chronic disease management. Evidence throughout the world suggests that, to be successful, policy-makers should consider:

− providing strong leadership and vision at the national, regional or organizational level;

− ensuring robust collection of information and data-sharing among all stakeholders;

− providing care based on people’s needs and an ability to identify people with different levels of need;

− targeting key risk factors, including widespread disease prevention initiatives;

− supporting self-management and empowering people with chronic diseases; and

− involving a wide range of stakeholders such as individuals, the voluntary and community sector, clinicians, private industry and public services.