WONCA Special Interest Group: Non-communicable diseases

Non-communicable diseases

A new WONCA Special Interest Group on Non-Communicable Diseases (NCDs) was approved by the WONCA Executive in July 2013 and serves as a focus for the development of NCDs issues for Wonca worldwide.

Read about why we need a Special Interest Group on Non-Communicable Diseases here.

General membership is open to interested family doctors. For more information email convenor or complete a brief application by clicking the link below.

Convenor / Chair

Convenor: Prof Domingo Orozco-Beltran (Spain)

email convenor

Domingo works in a health centre (Centro de Salud Cabo huertas, Alicante, Spain) and in a research unit (Departamento Univiersitario San Juan de Alicante). He is also professor at the University Miguel Hernandez. At this moment he is focused on research in primary care specially on patients' chronic conditions. He is chair of Spanish National Board on Family Medicine Teaching Programme and also chair of the Scientific Committee for Chronic Conditions Management Program from the Spanish Ministry of Health.

As convenor of the SIG on noncommunicable diseases he hopes to work to improve the management of NCDs through the SIG. We will try to write some joint papers with international institutions in order to empower primary care as the main setting to manage NCDs.

Co-Convenor or other office bearers

Co-convenor: Dr João Sequeira Carlos (Portugal)

João is the chair of the General and Family Medicine Department at the Hospital Da Luz in Lisbon. See more about João

Secretary: Prof Manuel Sanchez-Molla. (Spain)

Manuel usually works in a health centre (Centro de Salud Raval, Elx, Spain). But for the past few years has been involved in management (Departamento Univiersitario de Elx). He is also professor at the University Miguel Hernandez. Currently he is the director of Elche’s University Department, Including one university hospital and 10 primary care centres.

Executive Members

Membership Open?

Vision and Mission of WONCA SIG on Non-communicable diseases


To improve the role of primary care physicians in non-communicable diseases' management, around the world.


To provide new tools improving quality of care in terms of efficiency, equity and efficacy for patients with chronic conditions in primary care.

Objectives of the WONCA SIG on Non-communicable diseases

Our objectives include:
• To serve as a focus to stimulate and promote standards of excellence in the primary care management of NCDs, consistent with patient and professional values and with reference to evidence based health care
• To improve knowledge about chronic care models as Chronic Care Model (CCM) or Kaiser Permanente (KP) and others.
• To analyse the relationship between primary care orientation and the implementation of the chronic care models.
• To promote and to assess tools to Measure Quality Improvement of Chronic Illness Care
• To put people at the centre of health care by adopting, as appropriate, delivery models focused on the local and district levels that provide comprehensive primary health care services.
• To promote integrated care.
• To address the fragmented nature in which health care is delivered.
• To identify characteristics that facilitates the implementation of strategies to achieve a high performing chronic care system in primary care.
• To hold scientific meetings, which may include sessions and workshops during WONCA regional and world conferences. To present original papers and to address broader educational issues through discussion, training and debate.
• To promote and develop patient information about NCDs.
• To promote active participation by all people, and re-emphasise the empowering of communities, especially women, in the processes of developing and implementing policy and improving health and health care,.
• To develop and promote appropriate literature for primary care professionals using a variety of resources, including WONCA Online.

Publications & Documents


Plans of SIG on Non-Communicable Diseases

Our Activities
• Guideline development on NCDs issues
• Scientific presentations on NCDs
• Advice to WONCA and affiliated Colleges on NCDs issues
• Participation in Wonca activities and conferences with a focus on the NCDs health agenda
• Provision of a regular newsletter and educational materials
• Supporting the NCDs models in primary care education
• Organising regular online Primary Care NCDs Grand Rounds
• Developing and supporting postgraduate accreditation programms for General Practitioners with a Special Interest in NCDs

Our Proposed Products
• Culturally sensitive guideline (near future)
• Newsletter and regular communication to members
• References of interest

Our Proposed Meetings
• Annual scientific symposium at a WONCA regional / world meeting
• Annual general meeting at a WONCA regional / world meeting
• Regional / national workshops scientific and educational meetings to be organised by the committee

Proposed Collaborations
Co-operating organisations eg WPA, WHO, reputable patient representative groups, all WONCA Working Parties and WONCA Special Interest Groups will be approached to propose members to join the Working Party Executive on specific projects. All WONCA  regions will be approached to send representatives to become members of the SIG Executive.


Relevant Resources

WHO Montevideo Roadmap 2018-2030 on NCDs as a Sustainable Development Priority

United Nations high-level meeting on noncommunicable disease prevention and control. NCD summit to shape the international agenda. 19-20 September 2011. New York, USA. download here

Journal articles of relevance

Hansen J, Groenewegen PP,  Boerma WGW, Kringos DS. Living In A Country With A Strong Primary Care System Is Beneficial To People With Chronic Conditions. Health Affairs 34, No. 9 (2015): 1531–1537 doi:10.1377/hlthaff.2015.0582

Wallis KA, Andrews A, Henderson M. Swimming Against the Tide: Primary Care. Physicians' Views on Deprescribing in Everyday Practice. Ann Fam Med. 2017. Jul;15(4):341-346. doi: 10.1370/afm.2094. PubMed PMID: 28694270; PubMed Central. PMCID: PMC5505453. Full text:
Interventions to support safer prescribing in everyday practice should consider the sociocultural, personal, relational, and organizational constraints on deprescribing. Regulations and policies should be designed to support physicians in practicing according to their professional ethical values.

Demeyer H, Burtin C, Hornik M, Camillo CA, Van Remoortel H, Langer D, Janssens W, Troosters T. The Minimal Important Difference in Physical Activity in Patients with COPD. PLoS One. 2016 Apr 28;11(4):e0154587. doi:10.1371/journal.pone.0154587. eCollection 2016. PubMed PMID: 27124297; PubMed Central PMCID: PMC4849755. Full text:
The minimal important difference after pulmonary rehabilitation in patients with COPD lies between 600 and 1100 steps.day-1. The clinical importance of this change is supported by a reduced risk for hospital admission in those patients with more than 600 steps improvement.

Leelakanok N, Holcombe AL, Lund BC, Gu X, Schweizer ML. Association between polypharmacy and death: A systematic review and meta-analysis. J Am Pharm Assoc (2003). 2017 Nov - Dec;57(6):729-738.e10. doi: 10.1016/j.japh.2017.06.002. Epub 2017 Aug 5. PubMed PMID: 28784299. Full text:
Pooled risk estimates from this meta-analysis reveal that polypharmacy is associated with increased mortality risk. The causality of this relationship remains unclear, but it emphasizes the need for approaches to health care delivery that achieve an optimal balance of risk and benefit in medication prescribing.

Barker I, Steventon A, Deeny SR. Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data. BMJ. 2017 Feb 1;356:j84. doi: 10.1136/bmj.j84. PubMed PMID: 28148478. Full text:
Strategies that improve the continuity of care in general practice may reduce secondary care costs, particularly for the heaviest users of healthcare. Promoting continuity might also improve the experience of patients and those working in general practice.

Smith SM, Cousins G, Clyne B, Allwright S, O'Dowd T.Shared care across the interface between primary and specialty care in management of long term conditions. Cochrane Database Syst Rev. 2017 Feb 23;2:CD004910. doi: 10.1002/14651858.CD004910.pub3. Accessed here
Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. This review suggests that shared care improves depression outcomes and probably has mixed or limited effects on other outcomes.

Schilling L, Chase A, Kehrli S, Liu AY, Stiefel M, Brentari R. Kaiser Permanente's performance improvement system, Part 1: From benchmarking to executing on strategic priorities. Jt Comm J Qual Patient Saf. 2010 Nov;36(11):484-98. PubMed PMID: 21090018.

Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002 Oct 16;288(15):1909-14. PubMed PMID: 12377092.