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What is Chronic Disease Management

What is Chronic Disease Management?

Living with a chronic disease can sometimes feel like an uphill battle, with physical discomfort being one of the many challenges. However, with effective management, you can regain control of your health and improve your overall well-being. In this article, we will explore what chronic disease management entails and how it can help individuals with long-term health conditions.

What are chronic diseases?

Chronic diseases are health afflictions that often progress slowly. They are frequently lifelong and call for continual medical care as well as dietary and lifestyle changes, such as heart disease, stroke, cancer, diabetes, and respiratory illnesses.

How can chronic diseases impact the patient

What are the chronic diseases prominent among Singaporeans?

In Singapore, one in four people between the ages of 18 and 69 have at least one chronic illness, according to the National Health Survey 2020. Here are some of the common conditions which citizens face or are at risk of developing.

Cardiovascular disorders, such as heart attacks, accounted for one in three deaths in 2021, while strokes were responsible for 6% of fatalities. These conditions happen when the blood supply to the heart or brain is blocked, often by a blood clot. They are also a leading cause of death, and


This is characterised by persistently high blood pressure against the artery walls. One in four Singaporeans aged 30 to 69 are affected by it, making it a widespread problem in the country. If untreated, hypertension can cause serious health issues like heart disease and stroke. Because it typically exhibits no symptoms it is also referred to as a “silent killer”.

Diabetes affects the body’s ability to use the energy found in food. With one in nine adults aged 18 to 69 having diabetes, Singapore has one of the highest rates of the disease among developed countries. It’s a significant health concern because it can lead to other health complications like kidney failure, heart disease, and stroke.

Asthma is a chronic lung disease that inflames and narrows the airways, causing recurring periods of wheezing, chest tightness, shortness of breath, and coughing. While there’s no cure for this, its symptoms can be managed with medication and by avoiding triggers like dust mites, tobacco smoke, and air pollution.

It is caused when there’s an excessive amount of cholesterol in the blood. It’s also a significant health concern in Singapore and is mainly attributed to dietary habits. This can lead to atherosclerosis, a disease where plaque builds up in the arteries, increasing the risk of heart disease and stroke.

Cancer is a leading cause of death in Singapore. It’s a group of diseases characterised by the uncontrolled growth and spread of abnormal cells. The most common types of cancer in Singapore are breast cancer for women and colorectal cancer for men.

How can chronic diseases impact the patient?

Chronic diseases can significantly impact a patient’s quality of life as they can lead to physical discomfort, limit daily activities, and cause emotional distress. Additionally, they can also result in financial burdens due to ongoing medical costs. Managing symptoms, dealing with limitations in daily activities, and the need for long-term care are some of the challenges individuals may face.



 There might be changes to the patient’s appearance due to the condition, which may cause their self-esteem to fall. This can cause a withdrawal from hobbies, friends, and family, leading to isolation as well as an increased risk of developing mood disorders. Depression along with anxiety are common disorders that can be seen in patients with chronic disease, however, they are extremely treatable through proper interventions.


Financial difficulties:

 Having a chronic disease may impact an individual’s ability to hold down a job by limiting their range of movements, along with affecting the work they can perform. If this affects a patient’s employment, it may contribute to developing or worsening financial difficulties. It can also impact their access to medical care as the costs associated with medical appointments, medications, and treatments can easily pile up.



 The uncertainty and unpredictability of chronic diseases can increase stress levels. Additionally, managing medical appointments, medications, and treatment plans can be overwhelming. Chronic stress can have a negative impact on overall well-being and may even worsen symptoms of the underlying condition.


Relationship strain:

The increased demands of managing a chronic condition may strain relationships and create conflicts. Loved ones may struggle to understand the complexities and challenges of the disease, leading to frustration and tension. The patient’s needs for support and care may also burden their caregivers, affecting their emotional well-being and creating additional stress within the family dynamic.

What is included in chronic disease management

What is included in chronic disease management?


Proper medical care is essential in managing chronic diseases. It involves creating a personalised treatment plan that considers the patient’s unique health needs and preferences. This includes medication management, coordinating care among different healthcare providers, and regular health screenings.


Changing one’s lifestyle is crucial to managing chronic diseases. Patients can improve their health and control their condition by adopting a balanced diet, exercising frequently, managing their stress, and obtaining enough sleep. Simple changes to daily habits can make a significant difference.

Education plays an important role in empowering individuals to understand their condition better. Self-management education programs and resources provide valuable knowledge and practical skills for managing chronic diseases. Patients are encouraged to actively participate in their care, ask questions, and make informed decisions.


Support systems, such as family, friends, and community resources, play a crucial role in chronic disease management. They can come in the form of support groups, online communities, and counselling services to provide emotional support, share experiences, and offer valuable advice.

Regular monitoring and follow-up appointments help track disease progression, adjust treatment plans, and address emerging issues promptly. By staying proactive, patients can stay on top of their condition and prevent complications.

Why is patient engagement important in chronic disease management?

When patients are actively engaged in their healthcare, they transition from being passive recipients to active participants. This shift can have significant impacts on their treatment outcomes.


Fosters a sense of ownership and responsibility:

When patients are involved in their care, they are more likely to adhere to treatment plans and make lifestyle changes that can positively impact their health. This could mean following medication schedules more accurately, making dietary changes, or incorporating recommended physical activities into their daily routine.


Promotes personalised care:

Every patient is unique, with different needs, preferences, and experiences. By actively participating in their healthcare, patients can voice their concerns, preferences, and values, allowing healthcare providers to tailor treatment plans that are not only medically sound but also align with the patients’ lifestyle and personal circumstances.


Lead to better health outcomes:

Engaged patients often have better clinical outcomes and lower healthcare costs. This is particularly important in chronic disease management, where long-term adherence to treatment plans can significantly affect the progression of the disease and the patient’s quality of life.

Why is patient engagement important in chronic disease management

What are the benefits of chronic disease management?


Improved care-coordination:

Chronic disease management programmes often involve a team of healthcare professionals working together to provide comprehensive care. This can lead to better coordination among different healthcare providers, ensuring that all aspects of a patient’s health are addressed. It also helps in avoiding duplication of services and ensures that all treatments align with the overall care plan.


Cost effective for patients:

Chronic disease can also place a huge financial burden on patients and their loved ones. However, through chronic disease management, it helps reduce healthcare costs by preventing hospitalizations and emergency room visits, improving medication adherence, and reducing the need for expensive medical interventions.


Better patient satisfaction:

By providing personalised, coordinated care, chronic disease management programmes can lead to higher patient satisfaction. Patients often appreciate the extra support and ease of access to care. Furthermore, effective management of chronic diseases can lead to improved health outcomes, which can also increase patient satisfaction.


Does the Singaporean Government have a programme for chronic disease management?

There has been a comprehensive programme in place known as the Chronic Disease Management Programme (CDMP). This initiative was introduced in October 2006 by the Government with the aim of improving the accessibility, affordability, and quality of care for chronic disease patients in Singapore.


It covers 23 chronic conditions, from asthma, stroke, and hypertension, to anxiety, bipolar disorder, and schizophrenia. Through engaging more than 1000 clinics islandwide, the government has strived to make this programme as accessible as possible for citizens. This programme also involves public hospitals, polyclinics, Specialist Outpatient Clinics, as well as private specialist clinics to further broaden the range of coverage.


To alleviate the financial burden of managing chronic diseases, the Singaporean Government allows individuals to use their MediSave to pay for their treatment under the CDMP. Under the MediSave500 scheme, patients can use up to $500 per account per year to cover their outpatient bills. Each claim is subject to a 15% co-payment in cash. For patients with complex chronic conditions, they can use up to $700 per patient yearly from 1 Jan 2021.

What are the risk factors for chronic diseases?

Lifestyle Choices:


Unhealthy lifestyle choices such as poor diet, lack of physical activity, smoking, and excessive alcohol consumption can significantly increase the risk of developing chronic diseases like heart disease, stroke, diabetes, and cancer.


Family History:

Genetics play a crucial role in the development of certain chronic diseases. If a close family member has a chronic disease, you may be more likely to develop that disease, especially if multiple family members have had the condition.

Environmental Factors:

Exposure to certain environmental factors, including air pollution, secondhand smoke, and certain chemicals, can increase the risk of chronic diseases. Living or working in an unhealthy environment can expose you to them.


The risk of most chronic diseases increases with age. The longer we live, our bodies’ repair mechanisms can become less efficient. As a result, diseases like heart disease, cancer, and diabetes are more common in older adults.

Are you interested in knowing more about our Chronic Disease Management?


If you or a loved one has a chronic disease, it’s crucial to seek help from healthcare professionals who can guide you in managing the condition. Remember, such diseases can be managed effectively with the proper care and support, and you or your loved ones can lead a healthy, fulfilling life.

Contact us at Peak Medical today if you require any information or assistance regarding chronic disease management and we will get back to you soon.

We also provide a wide range of services that can suit your wants and needs.



Diabetes Singapore (2022, 12 January). The Singapore Demographics of Diabetes

The Singapore demographics of Diabetes


Ministry of Health and Health Promotion Board. (2020) National Population Health Survey 2020 https://www.moh.gov.sg/resources-statistics/reports/national-survey-2019-20


Ministry of Health and Health Promotion Board. (2021) National Population Health Survey 2021



Ministry of Health. (21 September 2022) Chronic Disease Management Programme (CDMP) https://www.moh.gov.sg/policies-and-legislation/chronic-disease-management-programme-(cdmp)


National University of Singapore. (2019, 1 January). High Blood Pressure