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InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-.
Disease management programs (DMPs) are structured treatment plans for people who have a chronic disease. They are also called “structured treatment programs.”
These programs are based on the latest medical research and aim to guarantee high-quality care for patients. DMPs ensure the close coordination of various treatments and regular check-ups, for example. But they also provide advice and instruction about coping with your disease.
In Germany, they have been offered by statutory insurers working together with doctors since 2002. Patient participation is voluntary and free of charge. Doctors who provide treatment as part of a DMP have to fulfill certain requirements and follow defined quality standards.
In Germany, DMPs are currently available for people with these chronic diseases:
Programs for other diseases are currently being designed, including osteoporosis, depression and chronic heart failure.
What is the aim of disease management programs?
The main goal of a DMP is to improve the care of people with a chronic disease. Treatment is based on the latest medical knowledge in order to relieve symptoms, keep the disease from getting worse and prevent complications from developing as much as possible.
In addition, this structured approach to treatment aims to improve cooperation between the various specialists and institutions that provide care, such as family doctors and specialists, hospitals and rehabilitation centers. This improved flow of information (using detailed documentation, for instance) is meant to ensure that the individual treatment steps are well coordinated and that the same medical test is not done twice by two different doctors.
Special training courses and regular consultations offer support for dealing with the disease. They also make it possible for people with a chronic disease to express their own preferences and needs, and actively take part in making well-informed decisions about their treatment All of these things together aim to improve the participants’ quality of life.
Who can participate in a DMP?
People with statutory health insurance who have a disease for which a DMP is available can sign up together with their doctor. If you have more than one of these diseases, you can also participate in multiple DMPs, with a few exceptions: It is not possible to be in DMPs for asthma and COPD at the same time. Participation in the soon-to-be-available chronic heart failure DMP and the coronary heart failure DMP is not allowed either.
Most of these programs are intended for adults over the age of 18. The DMPs for asthma and type 1 diabetes are available for children, though.
If you would like to participate in a DMP, but the doctor who is treating you doesn’t take part, you may have to change doctors.
How is treatment provided in a disease management program?
The doctor creates an individual treatment plan. This plan includes medication and other treatments, training courses and regular check-ups, some of which may be carried out by other doctors or hospitals. For example, the DMP for diabetes involves having regular eye tests in order to detect and treat possible complications early on.
At regular consultations patients can discuss the treatment and its goals while addressing their own needs and preferences. The individual therapy steps, as well as all the outcomes of tests and treatments, are documented electronically. This makes it easier for everyone involved with the therapy to trace these steps and to consider them in further treatment.
Patients who enroll in a DMP commit themselves to actively cooperate in their treatment – for example, by visiting a doctor every three or six months based on their individual situation. The participating health care providers – including doctors, hospitals, rehabilitation centers, nurses and trainers – commit themselves to fulfill certain quality requirements and follow the defined treatment plans.
Various things are done to assure quality of treatment in DMPs. The health insurers regularly assess data concerning the examinations, treatment steps and the results of the treatments. The doctors get feedback reports on their treatment outcomes, which are also compared with the outcomes achieved by other doctors’ practices. They also receive training regularly.
Patients can participate in a DMP for as long as they’d like. Only the breast cancer DMP is limited to ten years after the removal of the tumor, provided that no new cancerous tissue has developed.
How can I benefit from a DMP?
Chronic diseases require long-term regular treatment which should be tailored to suit the patient wherever possible. Participating in a disease management program might be a way to better cope with your disease in the long term and improve the success of your treatment. Taking part in a DMP may have some advantages, including the following:
- People who participate in a DMP work with doctors who have specialized in treating their disease.
- The recommendations for treatment are based on the current state of medical knowledge and are checked regularly.
- The doctors involved in a DMP are well-informed about the course of your treatment and will be able to give you more personalized attention during the regular appointments than they would be able to do in a normal consultation.
- All of the specialists involved, both in inpatient and outpatient treatment, are required to coordinate their interventions with one another.
- Special training courses can make it easier for people with chronic diseases to actively take part in making well-informed decisions about their treatment and in finding ways to live with their disease as well as possible.
Another reason some people find a structured treatment plan helpful is that it takes care of some practical issues for them: For example, they no longer have to look for suitable specialists or hospitals themselves, unless they want to.
What can I do if there is no DMP for my condition?
If the statutory health insurance funds don’t offer a disease management program for your disease, it does not mean that you have to go without a structured treatment plan (disease management). It is important to find a good doctor's practice that works in close cooperation with other therapists and institutions. If you and your doctor develop a personal treatment plan that suits you, and you attend regular appointments, you will already have the fundamental elements of good disease management. Last, but not least, reliable, comprehensive information can help you understand your disease better and learn how to live with it.
Sources
- Bundesamt für Soziale Sicherung (BAS). Zulassung der strukturierten Behandlungsprogramme (Disease Management Programme - DMP) durch das Bundesamt für Soziale Sicherung. 2023.
- Gemeinsamer Bundesausschuss (G-BA). Disease-Management-Programme. 2023.
IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.
- In brief: What are disease management programs (DMPs)? - InformedHealth.orgIn brief: What are disease management programs (DMPs)? - InformedHealth.org
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