Work package 7 – Training program for health professionals
In this WP a training program for health professionals will be developed to ensure adequate and successful implementation of the new chronic care model. As such, the program will focus on team-based care (coordination and integration instead of fragmentation of care delivery) and adequate prioritization of the multi-faceted needs of the ageing patient suffering from T2DM and related comorbidities. All other core elements of the model, such as correct pharmacotherapy in elderly suffering from several comorbidities, the use of telemedicine (for remote and continuous monitoring) and the empowerment of patients for improved decision making and for taking an active role in the management of their health condition will be included as well. In light of the patient empowerment, specific attention will be paid to the assessment of individual needs and priorities, the individualizedprioritization of management goals and the specificity of the patient’s involvement in reaching these goals. An e-health portal will be developed to make the training program accessible to all.