Endometriosis meets five of the six key elements that characterize chronic disease in Australia, and could therefore be reframed as such a disease. This would allow patients access to chronic disease management programs, according to researchers.
Their study, “Should endometriosis be managed within a chronic disease framework? An analysis of national policy documents,” was published in the Australian Health Review.
In Australia, chronic diseases are managed within a defined framework which allows the patients’ healthcare to be coordinated through programs such as the chronic disease management plan (CDMP) and team care arrangement (TCA).
To access the CDMP, a patient’s general practitioner must agree the condition “has been (or is likely to be) present for six months or longer.” CDMP is not limited to specific conditions as long as the patient meets this criterion.
In Australia, the implementation of CDMPs and TCAs have been conducted for a wider variety of chronic diseases, such as diabetes. The use of CDMPs and TCAs have been associated with an improvement in clinical outcomes, which highlights the benefits of management within the chronic disease framework.
Despite the fact that endometriosis is a persistent and long-term condition, it has not been formally classified as a chronic disease in countries such as the United States, United Kingdom, Canada, New Zealand, or Ireland.
In an effort to determine whether endometriosis can be classified as a chronic disease, Australian researchers set out to identify how these diseases are defined in Australian national policy documents and technical reports.
Researchers were able to identify 18 documents that contained a definition or characteristic of chronic disease.
From those documents, six key chronic disease elements emerged including “onset, causation, duration, treatment, disease course, and impact (individual and societal).”
Once identified, these key elements were compared to the descriptions of endometriosis in published literature, clinical practice guidelines, and expert statements.
Interestingly, this comparison found that endometriosis meets five of the six chronic disease key elements.
The one key disease element that is difficult to judge is whether endometriosis supports the theme associated with onset. Some women have symptoms in their teens, while others develop symptoms later in life.
“Because endometriosis has most of the characteristics of chronic disease, it could potentially be reframed … in endometriosis clinical practice guidelines and consensus statements,” the researchers wrote.
“Further, the use of CDMPs may provide a mechanism to promote individualized care and multidisciplinary management of this chronic, enigmatic and debilitating disease,” they added.
Additional benefits of reframing endometriosis could include increased recognition of the disease among healthcare professionals, the public and women’s support networks, as well as additional funding opportunities through the National Health and Medical Research Council of Australia.