Rejuvenating chronic disease management in Malaysian private general practice – a global perspective

Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension,diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, theseconditions are commonly managed in primary care and published evidence has consistently shown suboptimal managementand poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden tothe patients and their families with regards to morbidity and premature death, and burden to the country with regards topremature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases posea daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses.This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary careglobally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT(strengths, weaknesses, opportunities and threats) analysis; and discusses fundamental solutions needed to bridge the gapto achieve better outcomes.