Managing Chronic Conditions

To help patients successfully manage chronic conditions ranging from diabetes to mental illness, New Jersey healthcare institutions are taking a multi-disciplinary approach while utilizing the latest technological innovations.

By Jennifer Lesser, Contributing Writer On Dec 3, 2025

With chronic illnesses like cancer, heart disease, and diabetes on the rise – in fact, it is believed that some 60% of adults in the US are currently living with at least one chronic condition – New Jersey’s healthcare institutions are collaborating across disciplines while taking advantage of cutting-edge treatments in order to help residents manage their chronic conditions and lead active, fulfilling lives.

Arthritis

According to Dr. Humaira H. Khan, a rheumatologist at Virtua Health, arthritis is a broad term for disorders characterized by joint damage due to inflammation and degeneration. After relying on modalities such as newer laboratory tests and musculoskeletal ultrasounds for diagnosis, Dr. Khan says the goal is always to treat-to-target with the early initiation of effective therapies. “We take a multi-disciplinary approach, and our patients have access to other specialties in areas such as physical therapy, nutrition, sports medicine, pain management and orthopedics, which all play an important role in managing patients with arthritis,” she says. 

Depending on the type of arthritis, treatments can vary from exercise and weight reduction to the use of NSAIDs, Gabapentin or Pregabalin, intra-articular corticosteroids, viscosupplementation or even joint replacement for knee and hip osteoarthritis in advanced cases. Biologics, such as TNFs, can be used early in the disease process to control inflammation and limit joint damage.

“Virtua Rheumatology provides patient-centric care with a physician-patient partnership and shared decision-making. This lays the foundation for a long-term trusted relationship with improved compliance and better outcomes in chronic conditions like arthritis,” she says. 

Asthma

A chronic inflammatory lung disorder, asthma causes symptoms including wheezing, cough and shortness of breath. Some of the most common factors that exacerbate an asthma flare-up include environmental exposures such as grasses, pollen, trees and animal dander, as well as the changing of the seasons or weather.

“Having asthma that is uncontrolled or undermanaged can lead to persistent shortness of breath or wheezing that can be debilitating to a patient’s daily life and affect their ability to carry out daily tasks or enjoy their favorite activities,” explains Dr. Jeffrey D. Smith, a pulmonologist with Inspira Health. “Our goal as pulmonologists is to keep patients breathing as easy as possible and prevent any asthma exacerbations that could be severe enough to require treatment at the hospital.”

Typical treatment often includes inhalers with various combinations of medications that help relieve inflammation via different mechanisms. If inhalers are ineffective, there are other adjunct medications that are available. A newer class of medications known as biologics has become a standard of care for certain patients who qualify. Derived from living organisms or their components, biologic treatments are typically proteins, carbohydrates, cells, tissues or nucleic acids that can be used to treat a wide range of diseases. “These treatments are helpful for patients who have a robust immune system response as part of their asthma, and this medication class helps calm that response,” Dr. Smith explains. 

Alzheimer’s Disease

According to Dr. Kinga Kiszko, geriatrician at Valley Health System, Alzheimer’s disease (AD) affects more than six million Americans and is the most commonly occurring subtype of dementia. This disease damages the brain slowly and across multiple domains of function; not just memory but also thinking and behavior, making it difficult to manage daily tasks of life, and in late stages of the disease, impairing the ability to swallow safely and walk.

“My personal passion is prevention. I regularly talk to my patients about their diets, sleep quality, stress levels, mood, activity levels and support systems,” Kiszko says. “We work together to optimize health beyond treating individual diseases, but also through maintaining functional status and optimizing medications.”

When it comes to diagnosing Alzheimer’s disease, the FDA has approved blood-based Alzheimer’s tests such as p-tau217, p-tau181, and amyloid ratio assays to aid in early detection. Certain healthcare centers, including Valley Hospital, offer imaging such as the amyloid PET scan for further confirmatory testing.

“The evidence that I’m most excited about are the studies that allow me to promote better prevention; evidence-based medicine shows us that optimal blood pressure control (if able to be achieved comfortably) will decrease the risk for perpetuating the loss of memory in individuals with mild cognitive impairment,” she adds. Several diabetes drugs, including Metformin and GLP-1 agonists like Semaglutide (Ozempic), are actively being studied for potential neuroprotective effects through improved glycemic control and reduced neuroinflammation, Kiszko says.

Cancer

When it comes to managing a condition like cancer, Dr. James C. Wurzer, medical director of radiation oncology at AtlantiCare Regional Medical Center, also touts the importance of a multi-disciplinary approach; this avoids patients having to travel between multiple physicians or having to wait to be scheduled for scans or treatments. “We deliver comprehensive, patient-centered care because we have ‘tumor boards’ where we get everyone in the room – whether its radiation oncologists, surgical specialists or ancillary services staff – so we can take a team approach to determine the best course of action for each and every individual patient,” he says. 

In the field of cancer treatments and therapies in particular, technology has changed the playing field dramatically, from cutting-edge advancements in everything from genetic testing to radiation. According to Dr. Wurzer, radiation therapy can now enter a patient’s body with a guidance system that helps accurately track the tumor to ensure the radiation is delivered precisely, thus mitigating acute and long-term side effects. 

Meanwhile, radiopharmaceuticals are like a “smart bomb,” he says, as they can seek out cancer cells and bind to them, while genetic and genomic testing can help physicians analyze cancer cells to determine the most efficacious treatment. When it comes to surgical approaches, advancements in robotics as well as more minimally invasive and reconstructive approaches are allowing for faster recovery time and improved function. 

Heart Disease/Stroke/Hypertension

Hackensack Meridian Health (HMH) also believes in a collaborative approach to patient care when it comes to managing chronic conditions such as heart disease, stroke or hypertension. “When it comes to your heart, you want the absolute best. At Hackensack Meridian Health, we believe that instead of seeing one doctor at a time, you deserve an entire team of top heart experts – your personal ‘A-Team,’” explains Dr. David Landers, interim director of cardiology at Hackensack University Medical Center. “Think of it as a strategic huddle where surgeons, cardiologists, imaging experts and heart failure specialists gather to review your case together.”

Among the latest treatment options are minimally invasive procedures for structural heart disease, available for those patients who may be too high-risk for open-heart surgery. HMH physicians are now implanting the TriClip transcatheter edge-to-edge repair system (TEER) or the EVOQUE transcatheter tricuspid valve replacement system (TTVR) – first-of-their-kind treatment devices. The WATCHMAN™ Device is an implant for patients with Atrial Fibrillation (AFib) not caused by a valve problem, providing an alternative to long-term blood thinners.

HMH also has a network of designated Stroke Centers. Among the numerous innovations in stroke care is a mechanical thrombectomy for large-vessel-occlusion strokes. A neuro-interventionalist threads a catheter to the brain, using a stent-retriever or suction to physically remove the clot. Meanwhile, tPA (Tissue Plasminogen Activator) is a powerful clot-busting drug that can reverse the effects of an ischemic stroke if administered within a critical 3 to 4.5-hour window.

Back/Neck Pain; Migraines

One chronic condition that impacts countless New Jerseyans is pain, particularly neck and back pain as well as migraines. And according to Dr. Madouna Hanna, chair of physical medicine and rehabilitation at Bergen New Bridge Medical Center, the goal is to increasingly treat these patients without the use of opioids.

“Many patients come to me who had physical therapy that didn’t work, or injections that didn’t work … and so they were put on opioids. And it only took a week or two for them to become opioid dependent,” Dr. Hanna warns. As such, she treats conditions like migraines with alternatives such as nerve blockers or Botox injections, after more serious conditions like tumors or multiple sclerosis are ruled out. These alternatives also can help patients avoid the feelings of drowsiness or dizziness associated with some oral or injectable medications, she notes.

For back pain, nerve blockers as well as Radiofrequency Ablation (RFA) can be used as an alternative to opioids and other pain relievers. RFA is a minimally invasive procedure that relies on heat to destroy the nerves that are transmitting pain signals from the patient’s back. It can also be used on other types of pain, such as knee pain.

Childhood Diabetes

Like many other chronic diseases, childhood diabetes often requires meticulous planning and management as well as a deep understanding of the condition’s impact on the body. 

To that end, Children’s Specialized Hospital in New Brunswick offers The Chronic Illness Management Program, which includes a one-of-a-kind inpatient and outpatient multidisciplinary approach to diabetes management for children and adolescents. “We believe that solidifying the education and re-education of the management of a chronic disease like diabetes is incredibly important,” says Dr. Colin O’Reilly, vice president and chief medical officer from RWJBarnabas Health’s Children’s Specialized Hospital.

Within the program, children with diabetes have access to medical care, psychotherapy, nutrition therapy and education as well as disease-specific education, physical and occupational therapy, recreation therapy and child life services. There’s also an experiential learning component, such as cooking classes to help patients learn more about nutritional choices and food preparation that can help them manage their condition. Families and caregivers can also participate. 

“It’s important that when kids have this complex chronic disease that they learn to be the person who’s going to manage it; we make sure they know the ‘why’ behind certain treatments or lifestyle changes, and that they develop a true understanding of the disease itself,” Dr. O’Reilly says.

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