The efficacy of coordinated and patient centred care is established, but now is the time to test its effectiveness

See pp 954, 914, 925, 961

This is the third in the BMJ's series of theme issues on managing chronic diseases. This focus reflects the increasing demands on practitioners and health systems around the globe posed by mounting numbers of chronically ill patients.1 The term “chronic disease” usually connotes the prevalent chronic degenerative diseases such as diabetes, coronary artery disease, hypertension, and chronic obstructive pulmonary disease. But papers in the three theme issues argue that a much broader array of health problems generate similar needs for patients and similar challenges for health services—these include diseases such as chronic uveitis, gastro-oesophageal reflux disease, multiple sclerosis, depression, and osteoporosis.

Despite the clinical differences across these chronic conditions, each illness confronts patients and their families with the same spectrum of needs: to alter their behaviour; to deal with the social and emotional impacts of symptoms, disabilities, and approaching death; to take medicines; and to interact with medical care over time. In return, healthcare must …