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Mississippi Center Tackles Multiple Chronic Conditions

Patients who have two or more chronic health problems can be challenging for health center staff to target and treat. 

The Family Health Care Clinic, based in Pearl, Mississippi, recently decided to focus on a group of patients who had three simultaneous conditions: diabetes, high blood pressure, and high cholesterol. 

Family Health staff launched a study group that targeted more than 100 patients with this combination of conditions. Results were so good that they are now tracking about 250 patients and considering expanding the effort even more, said Margaret Gray, the health center’s CEO. 

“We’ve been very successful. We were able to control all three of those,” Gray said.  

How did they do it? They recruited patients to take part in the study group and asked them to come in at least quarterly. 

“The key is getting them to come in,” Gray said. 

The visits include comprehensive testing and a review of any medications.

Once the patients are on board with regular monitoring, staff members also provide dietary counseling and encouragement. For example, health center staff had noticed that some patients had a particularly tough time dealing with their conditions during the stretch of holidays that runs from Halloween to Valentine’s Day every year. 

Providers encouraged patients to expect holiday temptations and consider some healthier alternatives to overindulging in sweet treats, and the effort paid off, Gray said. 

“We were able to better control the highs and lows,” she said. 

The health center has an expansive service area of 21 counties, including rural areas in Mississippi, Alabama, and Louisiana, and Gray said staff hope to expand the effort to a wider group of patients. 

“We know we’ve got a good program,” she said.