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Health Care Challenge

Chronic disease is among the greatest challenge facing Ontario’s health care system, particularly in the context of a rapidly aging population. Nearly four million Ontarians over age 45 are living with a chronic disease or condition. About 70 per cent of these people are coping with two or more chronic diseases.

Many chronic diseases are linked to behavioural or lifestyle choices. For example, poor eating habits and lack of exercise are major contributors to type 2 diabetes and obesity. The direct and indirect cost associated with obesity in Ontario is estimated at $4.5 billion. Yet, chronic diseases are among the most preventable.

The prevalence and scope of chronic diseases threatens the future sustainability of the province’s health care system. Supporting patients to better self-manage chronic conditions can improve overall health outcomes and their quality of life as well as reduce the burden on the overall health system.

Real Change In Action

A successful chronic disease self-management program co-ordinated by Champlain Local Health Integration Network (LHIN) since 2009 has helped individuals and their families to better cope with their daily health challenges. The Central East LHIN has been running a similar program for about the same amount of time and the Toronto Central LHIN adopted a program within the last year. As of April 2011, chronic disease self-management programs were incorporated into all 14 LHINs in Ontario.

Since its inception, the Living Healthy Champlain program has supported and engaged nearly 1,000 individuals to take care control of their chronic conditions. The program consists of 2 ½ hour workshops that run for six weeks to help people better manage their symptoms and make positive lifestyle choices.

“Each week at the workshop a participant is responsible for coming up with an action plan for a change they want to achieve. It’s about empowering people and engaging them in their own care,” said Rachel Bowen, Regional Co-ordinator of Champlain LHIN’s Chronic Disease Self-Management Program.

The workshops are led by trained volunteers who are also coping with a chronic illness.  “The model involves lay peer leaders. Even if there is a health care provider involved they’re taking off their expert hat and relating as a person living with a chronic disease,” Bowen said. The program has trained over 70 volunteer leaders. The role of the leaders is to facilitate and provide feedback, but the workshops are driven by the participants who brainstorm and support one another, Bowen explained. “In between workshops, participants are paired with a buddy, who calls them to follow up on their action plan.”

The workshops support people with chronic conditions, including diabetes, arthritis, heart disease and asthma.  Participants learn and engage about healthy eating, exercise, pain, fatigue and stress management as well as managing medications and communicating with their health care professional. The workshops are free and participation is open to anyone who is interested.

The workshops are based on a program researched and developed at Stanford University that is considered a best practice in chronic disease self-management and that is offered in over 25 countries around the world. The Champlain LHIN adopted the program to ensure consistency in the delivery of self-management support. “Some services existed, but in silos of care. So we adopted the Stanford program, which offered the best evidence-based standard.”

A component of the Champlain LHIN’s program also involves training health care providers to facilitate self-management goal setting with their patients. About 300 health care providers annually participate in the training. “It involves of culture shift for health care providers to include this vital goal setting activity as part of their client care and service delivery aprroach. The training supports them in implementing these changes into their practice.”

Living Healthy Champlain is a coordinated effort between the Champlain LHIN, the Élisabeth Bruyère Research Institute, Bruyère Continuing Care and the Champlain Community Care Access Centre (CCAC).

Bowen and her counterparts at the other LHINs have formed a community of practice to share resources, experience and expertise. “The program has been really useful for those who are just starting out their programs.”

The Champlain LHIN’s program has been evaluated on an ongoing basis, Bowen noted. “The evaluation has continually shown an increase in self-efficacy among patients. They feel more confident in their ability to manage and communicate about their chronic illness.” The evaluation also found that participants were much more able to handle fatigue and emotional distress after completing the workshops. 

A recent testimonial from a program participant echoes this. “I am just completing the Living a Healthy Life with Chronic Conditions course and have found it to be very informative and thought provoking. Thank you for the opportunity to actively participate in improving the quality of my health and life in general,” the participant wrote.

Better Quality, Sustainable Care

Supporting Ontarians to better manage their chronic diseases improves not only their health outcomes, but also their quality of life. The expansion of chronic disease self-management programs across the province will equip more Ontarians with the tools to cope and actively manage their chronic conditions and stay healthier.  This will also positively impact the broader health system, through potentially fewer complications, reduced ER visits and hospitalizations. Helping people to help themselves not only improves their lives, but can also relieve some of the pressures on the health system.

For more information, contact:

Rachel Bowen
Regional Co-Ordinator
(613) 562-6262, ext. 1664

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