Chronic Disease Management


Is the management of a long-term health condition that needs ongoing treatment

A structured programme is in place for patients age 18 or over with medical cards or GP visit cards and who have a diagnosis of one or more of the following conditions

  • Type 2 diabetes
  • COPD, Chronic obstructive pulmonary disease
  • Cardiovascular disease including stroke, atrial fibrillation, heart failure, heart attack or angina.
  • Asthma

Working with the GP and General Practice Nurse you will be helped by having planned reviews of your disease and will agree a personalised care plan that addresses your needs and assists you to self-manage your condition.

You will be provided with education supports and be cared for in your community. Participating will help with early detection of any complications in your disease. The programme includes 2 free reviews in every 12 months. There is no charge for any tests that are carried out for your reviews.  Your reviews will be with both the GP and the practice nurse.