The rise of chronic conditions and why behavioural interventions are the future

By June 14, 2019 July 20th, 2019 chronic conditions

What are chronic conditions 

Chronic conditions are ongoing, generally incurable illnesses or diseases, lasting three months or longer, such as heart disease, asthma, cancer and diabetes. Often preventable, chronic conditions are frequently manageable through early detection, improved diet, exercise and treatment therapy. 40 million people in the United States alone are limited everyday in their day-to-day activities due to at least one chronic health condition. 

The differences between acute and chronic conditions vary greatly: the origins of an acute condition are often rapid, its duration short, with a diagnosis that is commonly accurate and comes with decisive diagnostic testing. Acute conditions are often rooted in a single cause, while treatment or cure may be fairly common. Chronic conditions, on the other hand, happen gradually, with its duration often indefinite. Diagnosis is often (frustratingly) uncertain, and diagnostic tests may come back with limited, if any, value. Chronic conditions can be rooted in many causes, often compounded upon each other. 

Sobering statistics 

According to the European Chronic Disease Alliance – which is comprised of a coalition of medical professionals and organizations – 40% of the population above age 15 (that equals roughly over 100 million European citizens) suffer from a chronic condition. That statistic continues to rise progressively with age seniority, resulting in millions of Europeans with at least one chronic ailment under their belt by the time they hit their retirement years. 

Chronic conditions…cost.

Chronic conditions also take a huge hit against the vast majority of health spending. In the US alone, total expenditure on public and private health care resulted in almost $2 trillion in 2005, with more than 75% of that amount being poured into chronic conditions and treatment. A study reported that seven chronic ailments – cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental illness – have a total impact on the US economy of $1.3 trillion annually, with this number projected to rise to $4.2 trillion in treatment costs and lost economic output by the year 2023. 

Chronic conditions, not just a first world problem   

Western countries are not the only ones in the deep end of the pool. Developing countries already bear more than 80% of the burden of chronic illnesses, with estimates that deaths from chronic diseases will rise by 15% between 2010 and 2020, with leaps of over 20% in Africa and South-East Asia. 

Chronic diseases may be some of the most impactful ‘imports’ to middle and low income countries. Africa may have long been the world’s poster child for diseases like AIDS and malaria, but the continent is quickly seeing a rise in a healthcare tipping point. African countries across the board are experiencing increased levels of smoking, alcohol and tobacco consumption, reduced physical activity, increased life expectancy (albeit small in some areas), as well as nutritional transition from traditional to a more western diet.

Chronic conditions, here for the long haul  

All of these aforementioned factors are contributors to the reason as to why the World Health Organization has predicted that over the next 15 years, sub-Saharan Africa will see chronic diseases such as cancer, heart disease, and kidney failure become major killers, accounting for a projected 42% of all deaths in the region by 2030, (up from 25% in today’s estimates). 

Generally incurable and ongoing, chronic conditions will continue to affect over 130 million Americans; that number is projected to rise to 157 million by 2020

Furthermore, chronic conditions can be disabling and reduce a person’s quality of life especially if left undiagnosed or untreated. For example, every 30 seconds a lower limb is amputated as a consequence of diabetes. More and more people are, on top of that, living with not just one chronic illness, but with two or more conditions. 

Moving forward 

Yes, chronic conditions cost lives and they reduce quality of life. They increase the demand and load on health care and drive up costs, but how to move forward with what’s ultimately best for the average sufferer? 

Certainly, it is widely accepted that a regimen of regular exercise can and will improve health, with promising outcomes resulting in chronic sufferers and some research suggesting that higher levels of physical activity may prevent or delay the onset or progression of an array of chronic ailments as well as improve overall quality of life.

Apart from moving away from a sedentary lifestyle and onto an active, healthier one, research has consistently shown that compliance with medical care and prescriptions is key in moving forward with an acceptable, if not relatively normal, quality of life. 

One of the most prevalent issues in a chronic sufferer’s behaviour is poor medication management. About 50% of all patients do not take their long-term therapy for chronic conditions as prescribed to them. It may be that they adhere quite well to prescription for one chronic condition, but not necessarily to the overall prescription regimen that is designed for other chronic conditions they are suffering from simultaneously. 

Why behavioural interventions are the future 

Failure to adhere to prescription intake is a complex and dynamic behaviour that may be linked to many factors, such as socio-economic backgrounds, the nature of the healthcare system they have access to, therapy-related factors, as well as patient-related factors. Whatever the case may be, such non-adherence to medication continues to be a big problem for healthcare advisors, not to mention poor outcomes for the patients themselves. This problem includes loss of treatment efficiency, increase in healthcare costs, rise in stress levels, as well as the possibility of death. 

The need to resolve such non-compliance of prescription becomes more urgent. 

The World Health Organization’s World Health Report 2003 reported that the degree of medical noncompliance is so great and the consequences so dire that people worldwide would benefit more from efforts to improve medication compliance than from the development of new medical treatments targeted at their chronic conditions. 

In developing countries, poor access to health care, possible lack of accurate diagnosis by licensed physicians, and overall limited availability of medications can be taken into account when we examine poor compliance to medication – but such factors threaten all efforts to treat chronic conditions such as diabetes, HIV, cancer, and even depression, that are all running rampant across the region. However, the rate of patients who persistently (keyword: persistently) take their medication for their chronic ailment actually drops significantly after the first six months

Another success story can be found in Rwanda, where deaths from Malaria are down 85% and tuberculosis by 77%. The fact that Rwanda’s healthcare has made dramatic strides in improving their systems and processes is one thing to be applauded, but these astonishing statistics are not just the result of more funding, but greater policies, improved education when it comes to why their chronic conditions are potentially life-threatening, as well as, ultimately, increased compliance in following medications accordingly.

This is why having the technology to facilitate better compliance with medication is key to establishing the next best step, behavioural interventions. Knowing what we now know about the average sufferer’s chronic dilemma, it is easy to see how software, like Textaid, intervenes at the ‘bottleneck’ area, acting as the middleman between physician/clinic and patient; educating the sufferer in terms of just how the chronic condition(s) is affecting the body, and reminding him or her of the importance of accurate medical intake, when and as required. Considering that chronic condition sufferers often are, or are heading towards, their winter years, software that facilities this easily and conveniently is a way of ensuring that they can still live a full and wholly manageable lifestyle.