Comparable ratios of physical to non-physical aggression to those reported by professional carers working in acute psychiatric treatment settings were reported. Carer-relatives require greater levels of information and support to assist them in their community caring roles.
Background Chronic non-cancer pain (CNCP) frequently co-occurs with other chronic conditions, resulting in multimorbidity. Objective The aim of this article is to summarise current approaches to CNCP management and explore areas of specificity and overlap with chronic conditions in general. Discussion The biomedical component of the management of chronic conditions may be condition-specific. However, mindbody, connection, activity and nutrition components entail significant overlap and are helpful across conditions. Effective practice avoids overemphasis on medical treatments at the expense of evidence-based, multidimensional lifestyle approaches. CNCP management illustrates the case for reconceptualising chronic condition management using a generic lifestyle-based approach. This capitalises on overlapping treatments, creates system efficiency and allows patients with multimorbidity to be treated more effectively in primary care, with only a small subgroup referred to condition-specific tertiary services. CHRONIC NON-CANCER PAIN (CNCP) is commonplace and costly. In 2018, 3.24 million Australians were living with CNCP, costing the country $73.2 billion. 1 In planning resource efficiency, it is noteworthy that CNCP often occurs in the midst of multimorbidity (Figure 1). A Scottish primary care study found that 23% of patients had multimorbidity and 46% of those presenting with CNCP had three or more long-term conditions. 2 Metaflammation has been postulated as an underlying mechanism contributing to many chronic conditions. 3 This may partly explain the overlap of effective lifestylebased treatment strategies. For example, increasing physical activity improves multiple chronic conditions. There are potential efficiencies in generic lifestylebased approaches to chronic conditions. Overinvesting in chronic conditionspecific programs may lead to unintended inefficiencies and costs. This article summarises current approaches to CNCP treatment and considers areas of specificity and overlap with generic chronic condition management (Figure 2).
In intermediate care facilities, the records of 41 patients who had fallen and 36 controls were reviewed retrospectively, and the two groups compared for demographics, diagnoses, blood pressures over the prior two months, and prescribed medication. Seven of the sample had a recent weight loss recorded; all seven were in the group that fell. The mean number of medications prescribed for the group of fallers was significantly greater than the mean prescribed for the control group. The mean number of medication changes during the two weeks prior to the fall was significantly greater than the mean number of medication changes during the two weeks prior to data collection for the control group. Our data suggest that caution should be exercised in multiple drug prescribing for patients in intermediate care facilities and that recent weight loss and medication changes may be risk factors for falling.
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