What is shared care?
Refers to the management of a patient with a chronic condition in an integrated manner, involving joint participation of GP and hospital specialists.
Explain concept of shared care for people w/ chronic illness?
- Involves the collaboration of both primary and secondary care physicians in the delivery of care.
- Enhances information exchange through discharge letters and emails e.g. dosage of medication to be prescribed by GP from the hospital specialist.
- Aim: To improve the coordination of care delivery
Why is shared care important?
- Ensure patients receive high quality care btw the handover of responsibility for management of their condition.
- Easier for patients to get their prescriptions close to home.
Role of clinical health psychologist
mental health- anxiety, depression
lifestyle impact
counselling
psychological influences on functioning
Role of physiotherapist
joint examination
range of movement
muscle wasting
exercise programme
promote self management
Role of occupational therapist
find alternative ways of doing tasks to make activates easier & less painful
home visits- aid & adaptions to support self management
Role of pain management team
try to reduce poly pharmacy
experts in understanding mechanism & management of pain
Role of specialist nurse
drug monitoring
psychical, psychological & emotional support
advice line support for patients & families
Role of rheumatologist
diagnosis
disease monitoring
prescription & monitoring of drug therapy
management of complications
inflammatory markers?
ESR
C-reactive protein
FBC
Rheumatoid Factor
- IgM-anti IgG most commonly measured
- good for RA- can be detected in health people- less accurate
Anti- CCP:
- found in RA
- associated w/ risk of joint erosions
ANA:
- detected using immunflorescnece
- positive ANA means antibodies present
