Full Description
Despite the astronomical costs of healthcare, patient outcomes remain suboptimal. While physicians are better than ever equipped to help patients address biomedical aspects of illnesses, medical training in psycho-behavioral, non-pharmacological illness management is lacking. Care of diverse, minoritized patients who are served in primary care may be particularly negatively affected. Specifically, primary care functions as the "de facto mental healthcare service"; however specialty referrals are frequently unavailable or poorly pursued, and many patients are either distrustful of or unable to afford pharmacotherapy.
While physicians may acknowledge the role of psychosocial and behavioral factors in etiology and maintenance of multiple conditions, they are ill prepared to discuss such mechanisms and management (outside of prescriptions and referrals) with their patients. As the symptoms of poorly managed chronic conditions do not improve over time (and periodically flare up), frustrated and scared patients are forced to return to treatment. In turn, physicians who focus exclusively on the biomedical illness aspects order more tests, place more referrals and prescribe more medications. Unfortunately, these efforts only lead to increased financial burden on both patients and healthcare systems, as well as potential for increased risks of medication and procedural side effects and incidental findings, without symptom resolution or reprieve.
Under current economic, social and political pressures, the practice of medicine is pushed towards increased patient-centeredness as well as growing focus on contextual and biopsychosocial factors. Ability to address such factors effectively is associated with decreased costs and better care. However, given multiple administrative and clinical demands, any interventions must also be brief and provide physicians and patients with practical and clear steps to facilitate discussion and promote patient engagement with proposed interventions.
A Practical Guide to Non-Pharmacological Care aims to address the existing gap in knowledge and skills by providing clear, practical and succinct guidance to physicians with focus on psychiatric and chronic pain conditions as these require non-pharmacological interventions for sustained symptom improvement.
Contents
Introduction.- Part I.- Somatic Symptom Disorder and Illness Anxiety Disorder.- Panic Disorder.- Posttraumatic stress disorder PTSD.- Insomnia.- Pat II.- Non Pharmacological Assessment and Management of Chronic Pain in Primary Care.- Irritable Bowel Syndrome.- Fibromyalgia.- Headache.- Understanding Psychotherapy Services Crash Course for Physicians.
