GP Flashcards
(34 cards)
Define frailty
a reduction in the bodies in built reserves, which is generally due to the cumulative effect of range of individual defects
What is frailty associated with
chronic disease
co-morbidities
What is the effect of frailty on mortality
Increases (even with adjustment for other factors)
What medication risks are associated with multi-morbidity?
- adverse effects
- inappropriate prescription
- prescription mistakes
- complex regimen for patients
Positive characteristics
- resilience
- independence
- patience
- determination
What factors affect a person’s capacity to cope?
- personal attributes and skills
- support network
- life workload
- physical and cognitive abilities
- financial status
- Environment
Negative characteristics
- Disorganization
- Poor engagement
- Worry
- Frustration
What makes up the obesogenic environment
- societal influences
- food consumption
- food production
- biology
- individual psychology
- individual activity
- activity enviroment
What drugs promote weight gain?
Insulin, sulphonylureas, thiazolinidiones - Diabetes Beta-blockers - Hypertension Corticosteroids - Inflammatory disease Cyproheptadine - Allergy, hay fever Antipsychotics - Psychosis Sodium valproate - Epilepsy Tricyclic antidepressants - Depression Lithium - Bipolar disorder
What are the SIGN guidelines for weight management?
based on the individual’s comorbidities and risks, rather than their weight alone
In what BMI bracket are obesity-related
comorbidities are less likely to be present?
BMI 25-35 kg/m2
In what BMI bracket are obesity-related
comorbidities are more likely to be present?
BMI>35 kg/m2
What is the weight loss target required
for cardiovascular disease and metabolic risk reduction
5-10% weight loss (approximately 5-10kgs)
What are the tier 1 measures in treating obesity?
Population wide intervention and prevention initiatives
- Information and guidance on healthy eating and physical activity
What are the tier 2 measures in treating obesity?
community weigh management service
- multicomponent weight management services, including primary identification, assessment and lifestyle interventions
What are the tier 3 measures in treating obesity?
Specialise weight management services
- multidsciplinary specialist treatmenrs, including pharmacotherapy, psychological assessment and low calorie diets
What are the tier 4 measures in treating obesity?
Surgical interventions
- pre-op assessment, bariatric surgery, post-op care
What diet is appropriate as treatment for obesity?
600 kcal deficit; higher protein/ lower carb = better
adherence
What physical activity is appropriate in obesity
45-60 mins moderate intensity/day
• ~2000 kcal/ week
What components of behaviour need intervention in obesity?
Self monitoring; stimulus control; goal
setting; relapse prevention
What components of behaviour need intervention in obesity?
Self monitoring; stimulus control; goal
setting; relapse prevention
What is treatment burden?
Treatment burden = workload of healthcare for individuals managing long-term health conditions and the impact on wellbeing
What are the two components of treatment burden?
- workload volume
- care deficiencies
What is illness work?
the “work” that patients and their families do to understand and “live with” a chronic illness
