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Caring for multiple chronic conditions need not be so complicated

Written by Diane Archer

Managing multiple chronic conditions can be as complicated as living with them. If you have multiple chronic conditions—conditions that are long-lasting and require medical attention—talk to your doctor about simplifying your treatment regimen.

About one in four Americans suffer from multiple chronic conditions, including obesity, diabetes, heart disease, high blood pressure, arthritis and high cholesterol.  And, having multiple chronic conditions generally means having multiple doctors, multiple medical appointments, multiple tests, multiple medications and multiple medical directives with which to comply.

Edie Grossfield reports for Next Avenue that the “burden of treatment” for people with multiple chronic conditions can be so great as to reduce the likelihood they will comply with their treatment regimens. It’s overwhelming. There’s a solution.

A new model of care, Patient Priorities Care, engages you in a discussion with your physician about your health care wishes and goals. What’s most important to you? Living a longer life, engaging with others, pain relief, mobility? Once that’s established, you can get a personalized treatment plan that is less of a burden on you.

Rather than ask patients an open-ended question like what are your treatment goals, Patient Priorities Care asks patients specifically what they want to be able to do on a daily basis. What gives you the greatest joy? What’s most important to you today?

To date, Patient Priorities Care has been tested on 350 people, and it appears to be an effective model. Patients report that it lightens their burden of treatment. They don’t have to deal with treatment regimens they’d prefer not to deal with or that they believe don’t work.

To be sure, patients often must accept trade-offs to benefit from Patients Priorities Care. For example, they might limit their medication intake in order to experience fewer side effects or get fewer lab tests. In the process they might end up living a little less long but a lot happier.

Patients involved in the study felt less burdened by their treatment because they received less “unwanted care,” including medications, diagnostic testing, procedures and self-management tasks that patients either didn’t believe helped them or thought was just too much.

The Patient Priorities Care model recognizes that we are all different. What works for some in the way of treatment will not likely work for all. Our bodies, our living situations, our relationships, our financial resources, our moods and more play a role in what works for us. The goal is to support us in the ways that best work for each of us.

Will the Patient Priorities Care model catch on? It’s hard to know. It means that doctors have to give their patients more time. And, time is limited. But, patients can and should initiate the conversation about their priorities with their doctors. The first couple of visits will likely be a bit longer, but after that they should return to their normal length.

If you speak to your doctor about streamlining your care regimen, keep in mind that Medicare requires doctors to follow disease treatment guidelines. However, those guidelines generally don’t apply to patients over 75 or 80. For other patients, physicians need only document the benefits of a different regimen for a patient.

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