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Symptoms in most chronic
illnesses are recurrent in the lives of chronically ill patients.
For example, arthritis is a chronic disease dominated by recurrent
pain, restricted mobility, and fatigue.
Other common conditions whose principal complaint is pain or other
distressing symptoms (e.g. back pain, headache, irritable bowel)
are also typically chronic-episodic. Thus, the organization of
health care for these conditions requires a long-term perspective
that includes routine assessment, planning, and follow-up. Using
arthritis as an example, we present a general model for the organization
of care for chronic illnesses (Wagner
et al., 1996a, 1996b;
1999),
and discuss key issues and research methods for developing and
conducting research in this area. While focusing primarily on
arthritis, the general principles in this paper are relevant to
other chronic conditions that cause symptoms and disability.
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