Advances in Chronic Disease Management

Topic Information

Dear Colleagues,

Chronic diseases are now the dominant drivers of preventable mortality, disability, and health expenditure worldwide. Their governance challenges go far beyond clinical management: chronic conditions unfold across long time horizons, require sustained adherence and lifestyle change, and depend on coordinated action among healthcare providers, patients and families, payers, communities, and broader social and digital environments. As health systems confront population ageing, multimorbidity, and widening inequities, improving chronic disease governance has become a central task for building resilient, people-centered healthcare system.

In this Topic, we focus on the governance of chronic diseases across policy, organizational, and community settings. We welcome research on governance models and institutional design; integrated care and medical–prevention collaboration; performance measurement and accountability; behavioral and incentive-based policy tools; digital health and AI-enabled governance (e.g., decision support, risk stratification, remote monitoring, and data-driven management); equity and access; patient engagement and trust; and comparative or case-based evidence on implementation, scale-up, and real-world impact. We are especially interested in work that bridges micro-level behavioral mechanisms with macro-level system arrangements, and that translates governance innovations into measurable health outcomes.

The Topic “Advances in Chronic Disease Management” provides a platform to publish high-quality reviews and original research papers. We encourage diverse methodological approaches, including quantitative studies, experiments, mixed methods, qualitative case analyses, implementation research, and policy evaluations. Please join us in creating a rigorous and practice-relevant collection of articles to advance governance solutions for chronic disease prevention and long-term management. We look forward to receiving your contributions.

Dr. Feng Jiang
Dr. Yuhui Ruan
Dr. Yilang Tang
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Behavioral Sciences behavsci	3.2	4.1	2011	27.7 Days	CHF 2400	Submit
Clinics and Practice clinpract	2.8	3.5	2011	24 Days	CHF 1800	Submit
Geriatrics geriatrics	2.4	3.4	2016	27.7 Days	CHF 1800	Submit
Healthcare healthcare	3.4	5.5	2013	21.5 Days	CHF 2700	Submit
International Journal of Environmental Research and Public Health ijerph	-	9.8	2004	24 Days	CHF 2500	Submit
Nutrients nutrients	5.8	10.2	2009	15.8 Days	CHF 2900	Submit

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Published Papers (8 papers)

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All Clinics and Practice Healthcare Nutrients Behavioral Sciences IJERPH Geriatrics

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Open AccessArticle

Willingness to Pay for Pharmacist-Led Weight Management Services in Community Pharmacies: A Cross-Sectional Study in an Academic Medical Center in Saudi Arabia

by Saja H. Almazrou, Danah Alwakail, Felwah Almanea and Shiekha S. AlAujan

Healthcare 2026, 14(13), 1953; https://doi.org/10.3390/healthcare14131953 - 2 Jul 2026

Viewed by 149

Abstract

Background: Obesity is a growing public health crisis in Saudi Arabia. Community pharmacists are well-positioned to deliver accessible weight management services, but data on public willingness to pay (WTP) for these interventions remains limited. Aim: To assess the willingness of the Saudi Arabian [...] Read more.

Background: Obesity is a growing public health crisis in Saudi Arabia. Community pharmacists are well-positioned to deliver accessible weight management services, but data on public willingness to pay (WTP) for these interventions remains limited. Aim: To assess the willingness of the Saudi Arabian public to pay for community pharmacist-led weight management services and identify factors associated with WTP. Methods: A cross-sectional, face-to-face survey was conducted among adults in a medical city in Riyadh between October 2025 and January 2026. WTP was elicited using the Payment Card method based on a hypothetical pharmacist-led service scenario. Payment values were validated by an expert panel. Univariable and multivariable regression models were used to identify independent predictors of WTP and payment amounts. Results: Of 746 participants, 66% expressed willingness to pay for the service. The most frequently selected maximum payment was 50 SAR per session. Multivariable logistic regression revealed that WTP was significantly associated with younger age, higher monthly income, perceived usefulness of pharmacy services (aOR: 3.10; 95% CI: 1.83–5.26), frequent pharmacy visits, and prior or desired access to a dietitian. Clinical burden, including BMI and chronic conditions, did not significantly influence WTP. Among those willing to pay, male gender was independently associated with a lower stated payment amount compared to females (β = −3.8 SAR; p = 0.006). Conclusions: Among adults attending a large academic medical city in Riyadh, there is substantial willingness to pay for pharmacist-led weight management services, with perceived value and healthcare engagement as the primary drivers. These preliminary findings warrant replication in broader, nationally representative samples. Full article

(This article belongs to the Topic Advances in Chronic Disease Management)

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10 pages, 411 KB  

Open AccessArticle

The Moderating Role of Digital Literacy in the Relationship Between Cognitive Function and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults

by Taejeong Jang

Healthcare 2026, 14(13), 1918; https://doi.org/10.3390/healthcare14131918 - 1 Jul 2026

Viewed by 124

Abstract

Background: As population aging accelerates, maintaining functional independence among older adults has become a critical public health priority. Cognitive function is a well-established determinant of instrumental activities of daily living (IADL); however, the role of digital literacy in shaping this relationship remains [...] Read more.

Background: As population aging accelerates, maintaining functional independence among older adults has become a critical public health priority. Cognitive function is a well-established determinant of instrumental activities of daily living (IADL); however, the role of digital literacy in shaping this relationship remains unclear. In the context of increasing digitalization, digital literacy may serve as a key factor supporting aging in place. Therefore, this study aimed to examine the moderating effect of digital literacy on the relationship between cognitive function and IADL among community-dwelling older adults. Methods: This descriptive cross-sectional study was conducted among 147 community-dwelling older adults aged 75 years and older. Cognitive function was assessed using the Korean version of the Montreal Cognitive Assessment (MoCA-K), IADL was measured using the Korean Instrumental Activities of Daily Living (K-IADL) scale, and digital literacy was evaluated using an 11-item dichotomous scale. Data were analyzed using descriptive statistics, Pearson’s correlation analysis, and hierarchical regression analysis. The moderating effect of digital literacy was tested using the PROCESS macro. Results: Cognitive function was positively correlated with digital literacy (r = 0.56, p < 0.001) and IADL (r = 0.26, p < 0.001), and digital literacy was also positively correlated with IADL (r = 0.25, p < 0.001). In the regression analysis, cognitive function significantly predicted IADL (B = 0.11, p = 0.004), but this effect became non-significant after including digital literacy in the model. A significant moderating effect of digital literacy was observed (B = −0.03, p < 0.001). Conditional effects analysis revealed that cognitive function significantly influenced IADL only among older adults with low levels of digital literacy (B = 0.12, p = 0.005), whereas no significant effect was found at moderate or high levels of digital literacy. Conclusions: Digital literacy significantly moderates the relationship between cognitive function and ADL among community-dwelling older adults. These findings suggest that digital literacy may function as a compensatory mechanism that mitigates the impact of cognitive decline on daily functioning. Enhancing digital literacy may represent an effective strategy to promote functional independence and support aging in place in an increasingly digital society. Full article

(This article belongs to the Topic Advances in Chronic Disease Management)

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27 pages, 942 KB  

Open AccessArticle

The Role of Advanced Practice Nurses in the Care of Multimorbid and Complex Chronically Ill Young and Middle-Aged Adults in Hospital Settings—Perspectives on Experience of APNs: A Qualitative Study

by Gabriele Bales, Birgit Schönfelder, Reto W. Kressig and Hanna Mayer

Healthcare 2026, 14(12), 1779; https://doi.org/10.3390/healthcare14121779 - 19 Jun 2026

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Abstract

Background/Objectives: The rising prevalence of multimorbid and complex chronically ill young and middle-aged adults necessitates the implementation of innovative care models and the creation of roles that can meet the complex healthcare needs of this patient group. Advanced Practice Nurses (APNs) can play [...] Read more.

Background/Objectives: The rising prevalence of multimorbid and complex chronically ill young and middle-aged adults necessitates the implementation of innovative care models and the creation of roles that can meet the complex healthcare needs of this patient group. Advanced Practice Nurses (APNs) can play a crucial role in the care of multimorbid and complex chronically ill young and middle-aged adults in APN-led clinics; however, in Switzerland, these roles are still evolving. The aim of this study was to explore APNs’ perspectives on the planned development of their roles in an APN-led clinic. Methods: To gain insights into the experiences of APNs in caring for this patient group, a qualitative study design was chosen. Data were collected through interviews with APNs from Switzerland, the USA, and Canada. In total, 19 APNs (12 from Switzerland and 7 from the United States and Canada) participated in the study. The data were collected through semi-structured online interviews. These data were analyzed using reflective thematic analysis in accordance with the approach presented by Braun and Clarke. Results: The analysis identified 10 themes that describe the competencies, components, and framework conditions required for the work of APNs in an APN-led clinic for multimorbid and complex chronically ill young and middle-aged adults within the Swiss clinical context. Required competencies include direct clinical practice, guidance and coaching, collaboration, and psychosocial support. Essential components include person-centered care, transitional care, and continuity of care. Key framework conditions include regulations of the legal and regulatory framework and eligibility for reimbursement of services, resources, and extended competencies and scope of practice. Conclusions: The perspectives of the APNs involved in this study show that multimorbid and complexly chronically ill young and middle-aged adults require complex and long-term care that extends beyond the hospital setting. The findings of this study show that Swiss APNs may be well positioned to contribute to this role. Full article

(This article belongs to the Topic Advances in Chronic Disease Management)

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18 pages, 1443 KB  

Open AccessCase Report

Challenges in Diagnosis and Management of Spondylodiscitis of L-5/S-1 Due to Propionibacterium acnes in a Patient with a Twenty-Year History of Tetraplegia

by Vaidyanathan Subramanian, Bakulesh Madhusudan Soni, Peter Lyndon Hughes and Tun Oo

Clin. Pract. 2026, 16(6), 106; https://doi.org/10.3390/clinpract16060106 - 31 May 2026

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Abstract

Objectives: To present novel strategies in the diagnosis and management of spondylodiscitis in a patient with tetraplegia. Case Presentation: A 44-year-old man presented with increased spasms despite having a SynchroMed II Medtronic for intrathecal infusion of baclofen. The C-reactive protein level was raised. [...] Read more.

Objectives: To present novel strategies in the diagnosis and management of spondylodiscitis in a patient with tetraplegia. Case Presentation: A 44-year-old man presented with increased spasms despite having a SynchroMed II Medtronic for intrathecal infusion of baclofen. The C-reactive protein level was raised. Infection was suspected, but there were no localising signs. Positron Emission Tomography (PET) was performed to identify the focus of infection. PET showed an increased Fluorodeoxyglucose uptake in the L-5 vertebral body and the associated ill-defined soft tissue anteriorly. There was significant erosion and destruction of the S-1 vertebra. Magnetic Resonance Imaging of the lumbo-sacral spine revealed destruction and collapse of the S-1 vertebral body and a 6 cm × 2 cm anterior paravertebral abscess collection. This patient was managed in his home. Intravenous administration of 1 g of Ertapenem daily was provided by community nurses for eight weeks. Blood tests were performed in the community setting, and the patient was monitored by spinal unit doctors. Results: Follow-up CT revealed abnormal soft tissue, expanding and replacing the S-1 vertebral body, with appearances in keeping with an infective process. Using CT guidance and the Madison bone biopsy kit, multiple cores were obtained from the left sacral bone. Four of the five specimens showed no growth after extended incubation. Propionibacterium acnes were isolated after 10 days of incubation from the tissue from the sacral bone biopsy only. A shared decision was made towards active surveillance. Follow-up CT of the abdomen showed a stable appearance of the lumbar and sacral spine. Conclusions: A complex case of spondylodiscitis can be diagnosed and managed while the patient stays mainly in their home, avoiding prolonged admission to the spinal unit, in alignment with the “hospital to community” aspect of the National Health Service’s 10-year Health Plan for England. A diagnostic pathway with PET-CT as the first approach proved useful when the site of infection was unclear. Active surveillance obviated the need for extended periods of antibiotic therapy, which could have led to complications such as antibiotic-induced toxicity and microbial resistance to antibiotics. Full article

(This article belongs to the Topic Advances in Chronic Disease Management)

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13 pages, 979 KB  

Open AccessArticle

Factors Associated with Long COVID in the Pediatric Population: A Retrospective Case–Control Study

by Ioana Maria Otilia Lică, Iulia Florentina Țincu, Anca Cristina Drăgănescu and Doina Anca Pleșca

Clin. Pract. 2026, 16(6), 105; https://doi.org/10.3390/clinpract16060105 - 31 May 2026

Viewed by 910

Abstract

Background: Long COVID in children is increasingly recognized, yet its clinical predictors and objective biological correlates remain insufficiently characterized. Objectives: The objective was to compare clinical, demographic, and laboratory characteristics between children with and without long COVID and to identify associated variables. Methods: [...] Read more.

Background: Long COVID in children is increasingly recognized, yet its clinical predictors and objective biological correlates remain insufficiently characterized. Objectives: The objective was to compare clinical, demographic, and laboratory characteristics between children with and without long COVID and to identify associated variables. Methods: We conducted a retrospective observational case–control study at the “Dr. Victor Gomoiu” Children’s Clinical Hospital, including pediatric patients with confirmed SARS-CoV-2 infection. Cases were defined as children with symptoms persisting ≥12 weeks after acute infection, while controls had no persistent symptoms at ≥12 weeks. Results: Eighty-nine children with long COVID and 88 matched controls were included. Children with long COVID were significantly older (1.79 ± 0.90 vs. 1.14 ± 0.80 years, p < 0.001) and more frequently from urban areas (86.5% vs. 69.3%, p = 0.0099). Lymphocyte, monocyte, and basophil counts were significantly lower in the Long COVID group, while D-dimer, ferritin, serum iron, urea, and creatinine levels were significantly higher. A multivariate predictive model demonstrated excellent discrimination (AUC = 0.94), with optimal sensitivity (84.3%) and specificity (89.8%) at a probability threshold of 0.48. Conclusions: Long COVID in children was associated with identifiable clinicobiological features. An exploratory composite model showed good discrimination but requires external validation. Full article

(This article belongs to the Topic Advances in Chronic Disease Management)

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Open AccessArticle

Association Between Anxiety and Suicidal Ideation, and Dietary Patterns

by Mir Jun, Jihyun Woo, Ju-Hye Chung, Se-Hong Kim and Youngmi Eun

Nutrients 2026, 18(10), 1568; https://doi.org/10.3390/nu18101568 - 14 May 2026

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Abstract

Background/Objectives: Diet is considered one of the most important modifiable risk factors for non-communicable diseases in modern society. While numerous studies have reported on the association between diet and mental health, including anxiety, research examining the relationship between dietary patterns and mental [...] Read more.

Background/Objectives: Diet is considered one of the most important modifiable risk factors for non-communicable diseases in modern society. While numerous studies have reported on the association between diet and mental health, including anxiety, research examining the relationship between dietary patterns and mental health is relatively scarce. Therefore, this study aimed to analyze the association between anxiety and suicidal ideation with macronutrient intake. Methods: This study was conducted on adults aged 19 years or older using raw data from the 2021–2023 Korea National Health and Nutrition Examination Survey. Excluding those with missing test items, 9002 subjects were included. The study subjects were divided into four groups based on macronutrient intake (normal diet group, high-carbohydrate diet group, high-fat diet group, and high-protein diet group; based on Korean Dietary Reference). Results: There was no significant association between dietary patterns and suicidal ideation. However, after adjusting for covariates for moderate or severe anxiety in the HP diet group, the odds ratio was reported to be 0.492 (95% CI 0.298–0.810). Subgroup analysis by gender revealed no significant difference between dietary types and anxiety in women, but in men, the HP diet significantly lowered the odds of moderate or severe anxiety (OR 0.230, 95% CI 0.089–0.599). Conclusions: This study found that higher protein intake was associated with lower levels of moderate to severe anxiety, and this trend was statistically significant, particularly in men. Further research is needed to confirm the causal relationship. Full article

(This article belongs to the Topic Advances in Chronic Disease Management)

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20 pages, 2160 KB  

Open AccessSystematic Review

Circulating Short-Chain Fatty Acid Levels in Chronic Kidney Disease: A Systematic Review and Meta-Analysis

by Devika Thakur and Matthew J. Harmer

Nutrients 2026, 18(9), 1440; https://doi.org/10.3390/nu18091440 - 30 Apr 2026

Cited by 1 | Viewed by 639

Abstract

Background: Chronic kidney disease (CKD) is characterised by a disrupted gut–kidney axis, wherein intestinal dysbiosis is associated with the accumulation of uraemic toxins and the potential depletion of beneficial short-chain fatty acids (SCFAs). Whilst acetate, propionate, and butyrate are known to modulate systemic [...] Read more.

Background: Chronic kidney disease (CKD) is characterised by a disrupted gut–kidney axis, wherein intestinal dysbiosis is associated with the accumulation of uraemic toxins and the potential depletion of beneficial short-chain fatty acids (SCFAs). Whilst acetate, propionate, and butyrate are known to modulate systemic inflammation and blood pressure, their precise circulating concentrations across different CKD stages and age groups remain poorly defined. This systematic review and meta-analysis aimed to quantify blood SCFA concentrations in CKD patients compared to healthy controls. Methods: We conducted a systematic search of Medline, EMBASE, and the Cochrane Library for clinical studies reporting blood SCFA concentrations in humans with CKD. Methodological quality was assessed using the NIH tool. Standardised mean differences (SMDs) were calculated for the quantitative meta-analysis, with subgroup analyses performed for age, CKD stage, and treatment modality (dialysis vs. transplantation). Results: Twenty-one studies encompassing 9661 participants were included. Quantitative synthesis revealed a significant and consistent systemic depletion of circulating acetate and propionate in adult CKD patients compared to healthy controls (p < 0.05). This depletion followed a stage-dependent trajectory, worsening alongside declining glomerular filtration rates. Notably, a “butyrate paradox” was identified in paediatric cohorts; whilst adults showed progressive butyrate depletion, children with CKD often maintained or exhibited elevated levels, particularly in the context of hypertension. Furthermore, whilst haemodialysis patients exhibited the most profound SCFA deficiencies, kidney transplantation appeared to partially restore these metabolites toward healthy baseline levels. Conclusions: CKD is associated with a profound systemic reduction in acetate and propionate, supporting the model of a compromised gut–kidney axis based on converging evidence. The divergent results for butyrate in paediatric versus adult populations suggest that SCFA metabolism is influenced by age-related factors or compensatory mechanisms. These findings highlight the potential for SCFA monitoring as a candidate or emerging markers for detecting early renal damage and stratifying risk. Full article

(This article belongs to the Topic Advances in Chronic Disease Management)

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15 pages, 412 KB  

Open AccessArticle

Role of South African Community Pharmacists in Wound Care: An Exploratory Study

by Ilse Truter, Janet Barry, Lara Cunningham, Alicia de Lange, Tifany Floors, Donnay Fourie, Sithembile Gumbi, Felicia Lategan, Mohale Leselo, Phelelani Mazibuko, Lukhanyo Ngalo, Sikelela Pangomso, Lisa-Nicole Scholtz, Zanele Tose and Johan Hugo

Int. J. Environ. Res. Public Health 2026, 23(4), 470; https://doi.org/10.3390/ijerph23040470 - 7 Apr 2026

Viewed by 794

Abstract

Community pharmacists are in a perfect position to offer comprehensive wound management advice to patients with both chronic and acute wounds, which can result in major costs and emotional burdens. A wound that is managed well through correct assessment, suitable treatment and follow-up [...] Read more.

Community pharmacists are in a perfect position to offer comprehensive wound management advice to patients with both chronic and acute wounds, which can result in major costs and emotional burdens. A wound that is managed well through correct assessment, suitable treatment and follow-up counselling will heal optimally and essentially save patients costs and stress. The study aimed to explore the role of South African community pharmacists in wound management. A list of community pharmacies was requested from the South African Pharmacy Council and an online questionnaire was conducted in August 2022 using QuestionPro^® Version 2. Stratified random sampling was used to select 350 community pharmacies out of a total of 3240 in South Africa. The response rate was 16.0% (n = 56). Half of the community pharmacists (n = 28) had adequate knowledge about acute wound care, with a third (30.4%, n = 17) indicating that they provide patients with chronic diabetic wound care advice at least once a week. Respondents indicated Continuous Professional Development (CPD) activities and reading journal articles, many relating to diabetic wound management, as ways in which they upskill themselves in wound care. Many of the respondent pharmacists were in favour of an increased focus on wound care services in their community pharmacies. Further training programmes and workshops could be offered to provide pharmacists with the knowledge necessary to manage both chronic and acute wounds in their pharmacies. Full article

(This article belongs to the Topic Advances in Chronic Disease Management)

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