DIABETIC PATIENTS WITH MULTIMORBIDITY IN FAMILY PRACTICE “Care for patient, not only for each disease”

摘要

Multimorbidity is usually defined as coexistence of two or more long-term chronic diseases in an individual. General practice office is a common place where patients with multimorbidity are received and treated. More than half of patients with diabetes mellitus are patients with multimorbidity. The strategy of family physician care for patients with multimorbidity insists on the specific process, which is patient oriented and not only towards one disease. Family physicians make decisions on the process of care for the patient with multimorbidity on the basis of records of the status of multimorbidity (all coexistent diseases), known comorbidity status (complications of diabetes), identification of acute episodes, diagnostic and therapeutic possibilities, and functional status.Treatment of patients with diabetes and multimorbidity poses specific demands in prescribing medication (patients use a large number of drugs in several daily doses), giving advice about self-management and improving understanding of medications, and referrals and diagnostic procedures