Providing comprehensive and continuing care to patients is the forte of family physicians. The burden of providing such care to patients with complicated co-morbidities is increasing rapidly in ageing populations. Primary care systems around the world are ill equipped to face such a challenge. Family physicians need to hone their skills in this area of care. In this article, we introduce the SBAR4 model and propose it as a framework for managing patients with complex co-morbidities. This model is easy to learn and use by family physicians as it is based on the familiar SBAR model of clinical communication and Pendleton's 7 Tasks of consultation. We believe that the SBAR4 will assist the clinician to assess patients with complex co-morbidities and map out a comprehensive care plan that can be easily understood by a multidisciplinary team caring for such patients.
Heart failure with preserved ejection fraction (HFpEF). His last 2-dimensional echocardiography (2DE) in March 2016 showed a calculated ejection fraction of 62 percent, impaired diastolic function, raised pulmonary artery systolic pressure of 43mmHg and severe tricuspid regurgitation due to right heart volume overload. 3. Atrial brillation (AF) not on anti-coagulants due to previous peptic ulcer disease and falls risk.
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