Putting a Public Health Face on Clinical Practice: Potential for Using an Infectious Disease Management Model for Chronic Disease Prevention
Donald O. Fedder
Chronic diseases are the major cause of death and disability worldwide, accounting for 60% of all deaths. This article presents a strategy that has been developed based on an infectious disease management model, to improve earlier detection and treatment of patients with chronic disease. We argue that one of the best ways to combat chronic and infectious diseases is through early detection, treatment, and follow-up, including major lifestyle and behavioral changes. We believe that the infectious disease control model offers opportunities that could be utilized in the prevention of chronic diseases. In this model, infected individuals or cases are identified and treated. This article proposes considering a chronic disease event - e.g. a heart attack, breast cancer diagnosis, or diabetes mellitus diagnosis - as the index case and then screening the siblings and progeny (their brothers, sisters, and children), who are predictably at higher risk of precursors and early disease markers. Early intervention (between the ages of 30 and 40 years in men and between the ages of 40 and 50 years in women) should reap major benefits in terms of risk reduction and lower disease exacerbation. A 5-6% change would have a profound impact on healthcare costs. More importantly, a major segment of the population would enjoy a better quality of life. The goal would be to increase their awareness, target risky behaviors, and promote preventive measures. This also suggests the need to develop a systematic process of monitoring feedback and periodic recall. This, in addition to improved primary prevention, is a reasonable secondary prevention strategy that may provide major benefits to large segments of society, both in the US and worldwide.
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