PRIISME helps primary care providers and patients manage chronic disease

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Do you know what patients with chronic disease such as diabetes, asthma or chronic obstructive pulmonary disease (COPD) find the most daunting?

According to a survey recently conducted by Leger Marketing, it’s navigating the health-care system. In fact, a majority of patients with chronic disease, and their families, found navigating the health-care system more daunting than the disease itself.

Multiple health-care professionals play a key role in helping chronically ill patients manage their disease – such as providing care, suggesting lifestyle changes and prescribing medicines. But patients often experience confusion because they receive conflicting information and direction.

In fact, the survey found that 22 per cent of Ontarians with chronic disease reported either themselves or their family member receiving conflicting information from their various health-care professionals during a six-month period. During this period, they received care from many different parts of the health-care system, such as family physicians at 87 per cent; specialists at 52 per cent; the emergency room of a hospital at 24 per cent; and a nurse, nurse practitioner or nurse educator at 26 per cent.

The good news for patients is the advent of a new program to help them and their health-care professionals better manage chronic illness. PRIISME, recently launched in five cities in Ontario, will help enable health-care professionals to deliver more integrated and coordinated care to patients with chronic disease and empower patients to take greater control of the management of their illness.

Our goal with PRIISME is to take our knowledge and resources within the hospital directly into the community, reaching health-care professionals and patients where chronic disease is most often managed. For example, in London we will be sending a diabetes nurse educator into the community to educate primary care providers and allied health professionals about practical ways to manage patients with diabetes according to the new guidelines. The nurse educator will be encouraging them to access the guidelines on-line so they can use them on a daily basis. This format will enable primary care providers to ask questions related to specific patients.

The nurse educator will also provide personalized education to patients including looking for ways to help diabetes patients with diet, lifestyle and exercise. As an example, by giving them a pedometer we can measure how much physical activity they are doing in a day and determine the number of steps they need to increase it (such as parking farther away from their destination, walking up an extra flight of stairs, etc.).

PRIISME is community-focused. If primary care providers and their patients receive the tools and information they need to effectively manage chronic disease, it will become the exception for patients with these chronic diseases to be treated in acute care settings. It will also help reduce health-care costs and give patients the ability and confidence to manage their illness independently.

The PRIISME program will launch in Ottawa, London, Mississauga and Kingston, with a focus on diabetes, asthma and COPD. Participating hospitals include The Ottawa Hospital (for asthma), St. Joseph’s Healthcare London (for diabetes and asthma), The Kingston General Hospital (for COPD), and both The Trillium Health Centre and The Credit Valley Hospital in Mississauga (for asthma).

PRIISME is an initiative of GlaxoSmithKline Inc. It was initiated in Quebec in 1999 to improve the management of asthma and based on its success, was recently expanded to help manage diabetes and COPD. There are currently more than 25 PRIISME projects in Quebec. More than 3,000 health professionals have been educated and 30,000 patients have received personalized education about managing their disease.

Evaluation of PRIISME projects for asthma have demonstrated an increase in patients’ quality of life, a decrease in emergency room visits and hospitalizations, a reduction in absenteeism rates, and more appropriate use of medications.

More than one-third of Ontario’s population suffers from a chronic disease and the numbers are expected to skyrocket by the end of the decade. As health professionals, we need to find ways to better integrate our care so that patients receive consistent information and are empowered to take control of their health. PRIISME is an excellent step in that direction.