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March 26, 2003

Self-management of Chronic DiseaseSelf-management of Chronic Disease

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(12):1508. doi:10.1001/jama.289.12.1508-a

To the Editor: Dr Bodenheimer and colleagues1 described a "collaborative care program for chronic disease management." The authors proposed increased "self-management education" as a central feature of their program. Unfortunately, this intervention is limited in scope and ignored a comprehensive systems-approach that has proven to be innovative and effective. For instance, the Diabetes Control and Complications Trial succeeded in decreasing and sustaining a significantly lowered hemoglobin A1c level during the 10-year duration of the trial.2

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