Long term health conditions Flashcards
(47 cards)
What is a long term health condition
A year or more of chronic, persistent, everyday long term symptoms
These conditions are typically not curable, but they can be controlled with medication and/or other treatments. Examples include diabetes, arthritis, asthma, and mental health conditions like depression or anxiety.
Core aims of LTCs care
Optimise QOL
Reduce impact on physical, social, emotional functioning
Prevent multi-morbidity (i.e. other LTCs developing)
Protect psychological wellbeing
Diagnose early, help with adjusting to living with a LTC, support self-management
What did Lambert & Keogh’s definition of LTC focus on?
The fact that LCTs change the life of the individual effected, generating a need to adapt - whether that’s to a diagnosis or to these ongoing symptoms - resilience
How many people in England are living with LTCs
15 million
Multimorbity group is growing
Link between LTCS and socioeconomic status
Those in the poorest social class have a 60% higher chance of having a LTC, 30% more severe, than those in the richest social class
Impact of LTCs on the NHS
50% of all GP appointments
Absorbs 70% of acute and primary care costs in the NHS
‘Multi-morbidity is now the norm’- current NHS care not set up to manage the complexity and demand of these LTCs
Multi morbidity
Defined as the presence of two or more long-term health conditions
e.g. hypertension and depression
King’s Fund, 2018
Identified top 4 risk factors had the most significant impact on people’s health:
alcohol
smoking
exercise
diet
Modifiable risk factors - not fixed and we can something about them
What are the mechanisms underlying these health inequalities between different social classes
Richer - access to private healthcare - diagnosis and treatment quicker
Stress mediator - associated with increased inflammation in the body
Processed food cheaper - IBD
Less access to green space
Multiple risk
Risk factors don’t often come in isolation - multiple risk should be taken as seriously as multi-morbidity
How many people exhibit 2 or more of these ‘big 4’ risk factors
7 in 10
more risk factors = higher mortality risk
What 3 things has risk been linked to
Prevention - early detection and intervention
Personal responsibility - educating people to make their own choices
Health inequalities - access to recourses should be equal
Examples of risk multi morbidity
Genetic predisposition to certain cancers and smoking
Stressful living environment and alcohol
The role of mental health in LTCs
Bidirectional
Examples where having a LTC may increase the risk of developing a mental health problem
Psychological impact of living with a LTC
Reductions in quality of life
Side effects of medications (e.g. sedation)
Physiological changes due to illness (e.g. hormone imbalances)
How can a mental health problem increase the risk of poorer physical health
Side effects of psychotropic medications (e.g. obesity)
Chronic stress leading to damage to cardiovascular / immune system
Unhealthy coping strategies (e.g. alcohol / poor diet)
Poor self-care / management of health condition
Naylor et al, 2012. Overlap between LTCs and mental health problems study findings
you’re more likely to have a physical health condition if you have a mental health condition than vice versa
So although it is bidirectional it is not equal in terms of prevalence
Reasons for why the prevalence is higher for mental health conditions
Misdiagnosis when older - if you have depression for example, it is more common for it to be attributed to something else such as medications and dementia
Why is there a call for integrating physical and mental health care
High rates of mental health conditions among those with LTCs
Reduced life-expectancy for people diagnosed with severe mental illness, largely due to poor physical health
Little psychological support currently available for people adjusting to and living with LTCs - need more health psychologists
Self management
Self-management of long-term conditions involves individuals taking an active role in managing their own health, including symptoms, treatment, and lifestyle changes. It empowers people to feel more in control of their health and well-being, leading to better outcomes.
Things we can do medically to self manage
Attending / organising health care appointments
Information processing - receive necessary info and education to self manage
Health literacy - comprehension
Coordination of care - someone that is actually coordinating and monitoring the system
Things we can do in the home environment to self manage
Healthy lifestyle
Medication adherence – taking medications, applying treatment regimes
Things to promote psychological wellbeing - sleep, exercise, social
Adapting to home, family, work environments
Managing / detecting symptoms, relapses or flare ups
What are intervention approaches for LCTs
Intervention approaches focus on empowering individuals to manage their conditions, improving their quality of life, and reducing healthcare costs. These approaches often involve a combination of medical treatments, lifestyle modifications, psychological support, and community resources.
Biomedical intervention approach
Focus: medical treatment
Goal: Reduce symptoms, manage disease progression
Limitations: Doesn’t address emotional or social needs of patients
