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Your Health

Disease management programme improves lives

 A doctor wearing blue scrubs and a stetascope is seated with a female patient. She is holding a Chronic Disease Management leaflet while he is taking her blood pressure.


“Anyone thinking of going on the programme, I would talk to your GP or your nurse, and get involved because it’s very beneficial,” according to Tina Maria Morrison, a patient under the HSE Chronic Disease Treatment (CDM) Programme.

“Personally, I find it’s great because I get my bloods checked every six months and then I know my levels and I can keep an eye on things. Generally, I know I’m on the right path. I can set goals for the next six months, so it’s very good.”

Speaking as a second review into the CDM programme was published in recent weeks, Dr Orlaith O’Reilly, HSE National Clinical Advisor, Chronic Disease, said they were “committed to enhancing healthcare in the community and bringing care closer to where people live.” That review showed that 91% of patients with chronic disease were now being fully managed routinely in primary care, rather than attending hospital, for their ongoing chronic condition.

Structured treatment programme

The programme supports GPs to provide a structured treatment programme for patients with one or more of four chronic diseases: asthma; type-2 diabetes; chronic obstructive pulmonary disease and cardiovascular diseases.

It is estimated that approximately 430,000 patients with chronic disease, or at high risk of chronic disease, will be registered when the programme reaches full implementation in 2023.

According to Dr Shane McKeogh, ICGP/HSE Clinical Lead for Adult Respiratory Disease: “As a GP, I’m very aware that patients living with these conditions are often some of the most vulnerable people in society. It is wonderful to be in a position to provide this programme of structured reviews for our patients right in their community through their GP and practice nurse twice a year.  At ground level, feedback from the programme has been hugely positive from patients and GPs alike.”


Since 2020, about 800,000 reviews of patients were carried out by doctors, with significant improving trends for lifestyle risk factors. These included a total of 13% of patients who gave up smoking between their first and third visits to the doctor. Of those reporting inadequate physical activity on the first visit, there was a 48% improvement by the third visit, with 30% achieving adequate levels of exercise. Among those with risk of alcohol behaviour, 67% were either normal drinkers or non-drinkers by the third visit.

Improvements in patients’ blood pressure, cholesterol and blood sugar levels were also observed over time.

Watch how the CDM programme benefits patients in Wexford -