Disease Management in Chronic Medical Conditions and its Relevance to Inflammatory Bowel Disease

The major reason behind the need for implementing disease management (DM) is the varitation in physician practice. DM involves medical decision making driven by data, and consists of identification of the patient group, interventionaccording to best practice guidelines, education to lessen physician variability and to improve patient compliance and ameasurement of outcomes to ensure that the result is beneficial. Proper implementation of this evidence-based approach has been difficult and slow, especially in the care of patientswith IBD where insufficient data are available to allow predictive stratification of patients or selection of managementoptions for both acute and maintenance phases of the diseases. Another reason that implementation of DM is difficult is that the concept of DM was in part based on business models,but health is not the same as money, as it is neither stable, nor can it be traded across time or individuals. Yet another reason why DM programs have been under-utilized is that the cost benefits of intervention programs areincompletely estimated, in part because the value assigned to quality of life varies so much between individuals.