Figure 1).

The burden of chronic diseases is tremendous, and traditional methods of health care delivery are unsuitable for addressing these needs. Chronic disease management has emerged as a new strategy for chronic disease care. Chronic disease management in the clinical setting is defined as an organized, proactive, multicomponent, patient-centred approach to health care delivery that involves all members of a defined population who have a specific disease entity (or a subpopulation with specific risk factors). Care is focused on, and integrated across, the entire spectrum of the disease and its complications, the prevention of comorbid conditions, and relevant aspects of the delivery system. Essential components include identification of the population, implementation of clinical practice guidelines or other decision-making tools, implementation of additional patient-, provider-or health care system-focused interventions, the use of clinical information systems, and the measurement and management of outcomes. It is said that few die from pain, yet many die in pain and even more live in pain