Long-term Conditions Flashcards
1
Q
DESMOND
A
T2DM education programme 6w
2
Q
DAFNE
A
T1DM education programme - 6w
3
Q
What is the ‘Advice & Guidance’ System
A
Referral system to 2ry care
4
Q
What makes a good referral letter?
A
- Q/request for 2ry care clinician
- outline what’s already been done & outcome
- pt functional level & communication difficulties
5
Q
What makes a good discharge letter?
A
- Diagnosis
- Treatment & investigations received
- Medication: changes & rationale
- Follow up: reasonable timeframe / where it will be (what for)
- Future: POC arranged? EoL discussed? What are future decisions
(Give Fit Notes in hospital or right time)
6
Q
Clinic letter
A
- problem list/diagnosis
- who responsible for prescribing meds changes
- organisation of drug monitoring
7
Q
Shared care agreement
A
- meds only prescribed in 2ry care followed up by 1ry care clinicians (need specific follow up/pathway)
i.e.- methotrexate & neutrophil monitoring
8
Q
Advantages of GP gatekeeping
A
- lower expenditures & efficiency
- reduced waiting times
- system needs referral mechanisms to manage demand
- specialists gain more expertise as see complex cases
- improves safety & prevents overtreatment
- reduces inequalities
- better communication (btw 1&2ry care)
9
Q
Drawbacks of GP gatekeeping
A
- delayed diagnoses, increased costs long term, impaired outcomes
- reduced patient choice, empowerment & DM
- hinders GP clinical knowledge
- potential source of conflict with pts
- increases GP workload
- relying on GPs to refer appropriately
10
Q
What 8 topics should be covered in an ‘impact of LTC’ Hx?
A
Timeline
Impact of age
Legitimacy
Societal reactions
Self-perception
Emotions
Uncertainty
Change in role
11
Q
Timeline
A
- how do you think the disease will progress?
- do you feel any control over this?
12
Q
Impact of age
A
- if illness is accepted as normal for age (i.e - osteoporosis) is there a lower expectation for quality of life?
13
Q
Legitimacy
A
- what is the impact of invisible conditions?
- what might the impact of perceived ‘self-inflicted’ illness be?
14
Q
Societal reactions
A
- societal expectation to ‘help yourself’
- society values independence & self reliance (it’s okay to need support)
- extent to which individual is given the right to & privileges of the sick role by those around them
15
Q
Self-perception
A
- can no longer rely on body to function as before, how does that make you feel?
- interaction with the world can seem perilous
