An empirical model for the development of disease management programs in general practice: A case study using hypertension

Objective: The aim of this research was to develop an empirically derived methodological model for the development of disease management programs in general practice. The model was developed applying the example of hypertension. Methods: Using a rapid appraisal framework, empirical investigations, which included structured panel discussions, face-to-face structured interviews and formal presentations, were conducted to design, test and confirm the disease management model. A broad range of stakeholders were consulted from general practice, other health providers, industry, federal government and consumers. Results: The outcome of the research was a testable definition of disease management for hypertension, and the Australian Disease Management Approach to Hypertension in General Practice (ADAGE) for patients at low to high risk of major cardiovascular events. The central platform of this program is an information, communication technology package for risk assessment and management, plus access to a dietician commissioned by the program and a tailored suite of audiovisual and written material. Conclusion: This study used hypertension to demonstrate a model for the development of theoretically sound disease management models for application in general practice. The ADAGE program is currently under evaluation in a cluster randomized trial of 76 general practices in South Australia and Victoria in both metropolitan and rural settings. It is anticipated that this model will contribute to the development of other disease management programs for addressing chronic disease.