Developments in person-centered coordinated care are essential given the challenges of the growing epidemic of physical comorbidity in the mentally ill population. Excessive deaths due to comorbidity, especially cardiovascular disease, continue to contribute to the significant reduction in life expectancy in people with mental health problems.Contemporary and proposed models are now available to provide evidence for a way forward in this field. Practical guidance on implementation using person-centered care planning has now been developed to promote a more collaborative and integrated approach as a solution to the current single disease focused model of care, which is failing this patient group. The WHO perspective supports this strategy with the recent global objectives outlining proactive and preventative strategies and interventions to tackle comorbidity. The emphasis is on a transformation of current systems using evidence-based approaches for more integration to support the delivery of more effective and efficient care for those with mental disorders and other comorbid chronic diseases.Coordinated, collaborative, system-wide strategies encompass transparent shared decision making in prevention, early intervention, treatment options, lifestyle management and pharmacological rationalization. Hence urgent action is required to help create the conditions to enable the delivery of person-centered coordinated care in health care systems by involving commissioning bodies, clinicians, patient groups along with voluntary and other community providers.Contemporary models of care for comorbidity emphasize the importance of coordination in the management of physical well-being from the onset of treatment of people with mental health problems in order to ensure better outcomes, improved overall well-being, and a longer life expectancy. Illustratively, no further funds are available to implement this shift in the model of care in the United Kingdom, so redesign and redistribution of current resources will be key to promote this more seamless coordinated system of care to improve the quality of life and life expectancy for this population.
{"title":"PERSON-CENTERED CARE PLANNING AND SHARED DECISION MAKING FOR MENTAL AND COMORBID CONDITIONS","authors":"H. Millar, I. Salloum","doi":"10.5750/ijpcm.v8i4.896","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i4.896","url":null,"abstract":"Developments in person-centered coordinated care are essential given the challenges of the growing epidemic of physical comorbidity in the mentally ill population. Excessive deaths due to comorbidity, especially cardiovascular disease, continue to contribute to the significant reduction in life expectancy in people with mental health problems.Contemporary and proposed models are now available to provide evidence for a way forward in this field. Practical guidance on implementation using person-centered care planning has now been developed to promote a more collaborative and integrated approach as a solution to the current single disease focused model of care, which is failing this patient group. The WHO perspective supports this strategy with the recent global objectives outlining proactive and preventative strategies and interventions to tackle comorbidity. The emphasis is on a transformation of current systems using evidence-based approaches for more integration to support the delivery of more effective and efficient care for those with mental disorders and other comorbid chronic diseases.Coordinated, collaborative, system-wide strategies encompass transparent shared decision making in prevention, early intervention, treatment options, lifestyle management and pharmacological rationalization. Hence urgent action is required to help create the conditions to enable the delivery of person-centered coordinated care in health care systems by involving commissioning bodies, clinicians, patient groups along with voluntary and other community providers.Contemporary models of care for comorbidity emphasize the importance of coordination in the management of physical well-being from the onset of treatment of people with mental health problems in order to ensure better outcomes, improved overall well-being, and a longer life expectancy. Illustratively, no further funds are available to implement this shift in the model of care in the United Kingdom, so redesign and redistribution of current resources will be key to promote this more seamless coordinated system of care to improve the quality of life and life expectancy for this population.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115172473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the first Peruvian Conference on Person-Centered Medicine, there are two concepts that were originally never separated: Comprehensive Health Care by All for All that Dr. David Tejada de Rivero articulated until his death at the end of 2018 and Person-Centered Medicine and Health that the International College of Person Centered Medicine and others have been promoting worldwide.From this perspective, it is completely natural to talk about Integral Person-Centered Health Care, because who, but the human person, is to whom integral health care can be directed. They join in this way, Alma Ata of 1978 with Lima of 2018, paying just tribute to the vision of the future from Halfdan Mahler and David Tejada de Rivero and posing a motivating stimulation to health professionals.
在第一届秘鲁以人为中心的医学会议上，有两个最初从未分开的概念:David Tejada de Rivero博士在2018年底去世前阐述的“人人享有全面卫生保健”，以及国际以人为中心的医学学院和其他机构一直在世界范围内推广的“以人为中心的医学与健康”。从这个角度来看，谈论以人为中心的整体医疗保健是完全自然的，因为整体医疗保健可以针对谁，但不是人。它们以这种方式将1978年的阿拉木图与2018年的利马结合在一起，向哈夫丹·马勒和大卫·特哈达·德里韦罗对未来的愿景致敬，并对卫生专业人员构成激励。
{"title":"REPORT OF THE FIRST PERUVIAN CONFERENCE ON PERSON-CENTERED MEDICINE","authors":"J. Mezzich","doi":"10.5750/ijpcm.v8i4.901","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i4.901","url":null,"abstract":"In the first Peruvian Conference on Person-Centered Medicine, there are two concepts that were originally never separated: Comprehensive Health Care by All for All that Dr. David Tejada de Rivero articulated until his death at the end of 2018 and Person-Centered Medicine and Health that the International College of Person Centered Medicine and others have been promoting worldwide.From this perspective, it is completely natural to talk about Integral Person-Centered Health Care, because who, but the human person, is to whom integral health care can be directed. They join in this way, Alma Ata of 1978 with Lima of 2018, paying just tribute to the vision of the future from Halfdan Mahler and David Tejada de Rivero and posing a motivating stimulation to health professionals.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"234 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115659943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shared decision making based on clinical evidence and the patient’s informed preferences improves patient knowledge and ability to participate in their care with improvement to those with long-term health problems.A common ground between the patient and the physician is achieved through empathic communication skills with the provision of evidence-based information about options, outcomes, and uncertainties, together with decision support counseling and a systematic approach to recording and implementing patient’s preferences.It is important to recognize that the complexities of the clinical decision-making process with the confounding variables create difficulties in obtaining and measuring reproducible outcomes.
{"title":"SHARED DECISION MAKING FOR OTHER GENERAL CONDITIONS","authors":"J. Appleyard, J. Snaedal","doi":"10.5750/ijpcm.v8i4.898","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i4.898","url":null,"abstract":"Shared decision making based on clinical evidence and the patient’s informed preferences improves patient knowledge and ability to participate in their care with improvement to those with long-term health problems.A common ground between the patient and the physician is achieved through empathic communication skills with the provision of evidence-based information about options, outcomes, and uncertainties, together with decision support counseling and a systematic approach to recording and implementing patient’s preferences.It is important to recognize that the complexities of the clinical decision-making process with the confounding variables create difficulties in obtaining and measuring reproducible outcomes.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116135409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Interprofessional collaboration (IPC) occurs when health workers with varying educational preparation and skills work together to deliver quality health services – as no single health professional can have all the required knowledge and skills. Governments and health policy makers are always looking for better ways of delivering care and IPC offers a smart solution to do this. Interprofessional education (IPE), an related concept, is a prerequisite in preparing a “collaborative practice-ready” health workforce that is better prepared to respond to local health needs. In interprofessional education, health workers, at some point during their training, learn together in order to work together.
{"title":"INTERPROFESSIONAL COLLABORATION FOR PERSON-CENTERED CARE","authors":"T. Ghebrehiwet","doi":"10.5750/ijpcm.v8i4.899","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i4.899","url":null,"abstract":"Interprofessional collaboration (IPC) occurs when health workers with varying educational preparation and skills work together to deliver quality health services – as no single health professional can have all the required knowledge and skills. Governments and health policy makers are always looking for better ways of delivering care and IPC offers a smart solution to do this. Interprofessional education (IPE), an related concept, is a prerequisite in preparing a “collaborative practice-ready” health workforce that is better prepared to respond to local health needs. In interprofessional education, health workers, at some point during their training, learn together in order to work together.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"249 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116393898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With medical care being increasingly driven by management systems founded on cost containment, cost efficiency, and cost efficacy, doctors are becoming burnt out especially in the United States within the complexities of an insurance-based system and in the United Kingdom by narrowly based directed government policies. Doctors are increasingly unable to fulfill their ethical obligations to their patients and are becoming “disconnected” from their work environment.
{"title":"SUMMARY REPORT OF THE SYMPOSIUM ON PERSON CENTERED MEDICINE AT THE WORLD MEDICAL ASSOCIATION ETHICS CONFERENCE IN REYKJAVIK 2018","authors":"J. Appleyard","doi":"10.5750/ijpcm.v8i4.900","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i4.900","url":null,"abstract":"With medical care being increasingly driven by management systems founded on cost containment, cost efficiency, and cost efficacy, doctors are becoming burnt out especially in the United States within the complexities of an insurance-based system and in the United Kingdom by narrowly based directed government policies. Doctors are increasingly unable to fulfill their ethical obligations to their patients and are becoming “disconnected” from their work environment.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130031670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Resulting from the First Peruvian Encounter of Person Centered Medicine with multidisciplinary participation, held in Lima, Peru on December 14 and 15, 2018, organized by the Peruvian Association of Person Centered Medicine and under the auspices of the Latin American Network of Person-Centered Medicine, the Latin American Association of National Academies of Medicine (ALANAM), the Peruvian Association of Faculties of Medicine (ASPEFAM), the Representation in Peru of the Pan American Health Organization (PAHO/WHO), San Marcos National University (Peru), the Regional Council III – Lima of the Medical College of Peru, and the International College of Person Centered Medicine.
{"title":"2018 LIMA DECLARATION TOWARDS THE LATIN AMERICAN CONSTRUCTION OF PERSONS-CENTERED INTEGRAL HEALTH CARE","authors":"J. Mezzich","doi":"10.5750/ijpcm.v8i4.895","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i4.895","url":null,"abstract":"Resulting from the First Peruvian Encounter of Person Centered Medicine with multidisciplinary participation, held in Lima, Peru on December 14 and 15, 2018, organized by the Peruvian Association of Person Centered Medicine and under the auspices of the Latin American Network of Person-Centered Medicine, the Latin American Association of National Academies of Medicine (ALANAM), the Peruvian Association of Faculties of Medicine (ASPEFAM), the Representation in Peru of the Pan American Health Organization (PAHO/WHO), San Marcos National University (Peru), the Regional Council III – Lima of the Medical College of Peru, and the International College of Person Centered Medicine.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128692598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This journal issue includes the third part of the Educational Program on PersonCentered Care of the International College of Person Centered Medicine (ICPCM) that in its initial version was presented at the 6th International Congress of Person Centered Medicine in New Delhi in November 2018. The overall themes of the four papers [1–4] are the planning of care, shared decision making, and interprofessional collaboration. In addition, there is the Lima Declaration 2018 entitled “Towards a Latin American Construction of Persons-Centered Integral Health Care,” which recognizes how important these concepts are to the
{"title":"EDITORIAL INTRODUCTION: ICPCM EDUCATIONAL PROGRAM ON PERSON-CENTERED CARE: CARE PLANNING, SHARED DECISION MAKING, AND INTERPROFESSIONAL COLLABORATION","authors":"J. Appleyard, J. Mezzich","doi":"10.5750/ijpcm.v8i4.894","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i4.894","url":null,"abstract":"This journal issue includes the third part of the Educational Program on PersonCentered Care of the International College of Person Centered Medicine (ICPCM) that in its initial version was presented at the 6th International Congress of Person Centered Medicine in New Delhi in November 2018. The overall themes of the four papers [1–4] are the planning of care, shared decision making, and interprofessional collaboration. In addition, there is the Lima Declaration 2018 entitled “Towards a Latin American Construction of Persons-Centered Integral Health Care,” which recognizes how important these concepts are to the","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"202 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134235060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Cancer raises many questions for people afflicted by it. Do I want to have genetic testing? Will I comply with screening recommendations? If I am diagnosed with it, where will I have treatment? What treatment modalities will I have? Will I go on a clinical trial? Am I willing to bankrupt my family in the process of pursuing treatment? Will I write an advance care plan? Will I accept hospice if I have run out of available treatment options? Most of these questions have more than one correct answer, and the evidence for the superiority of one option over another is either not available or does not allow differentiation. Often the best choice between two or more valid approaches depends on how individuals value their respective risks and benefits; “preference-based medicine” may be more important than “evidence-based medicine.” There are various models for eliciting preferences, but applying them can raise a number of challenges.Objectives: To present the concepts, the value, the strategies, the quandaries, and the potential pitfalls of Shared Decision Making in Oncology and Palliative Care.Method: Narrative review.Results: Some challenges to practicing preference-based medicine in oncology and palliative care include: some patients don’t want to participate in shared decision making (SDM); the whole situation needs to be addressed, not just part of it; but are some topics out of bounds? Cognitive biases apply as much in SDM as any other human decision making, affecting the choice; how numerically equivalent data are framed can also affect the outcome; conducting SDM is also important at the end of life.Conclusions: By being aware of the potential pitfalls with SDM, clinicians are more able to facilitate the discussion so that the patients’ choices truly reflect their informed preferences, at a time when stakes and emotions are high.
{"title":"SHARED DECISION MAKING IN ONCOLOGY AND PALLIATIVE CARE","authors":"P. Glare","doi":"10.5750/ijpcm.v8i4.897","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i4.897","url":null,"abstract":"Background: Cancer raises many questions for people afflicted by it. Do I want to have genetic testing? Will I comply with screening recommendations? If I am diagnosed with it, where will I have treatment? What treatment modalities will I have? Will I go on a clinical trial? Am I willing to bankrupt my family in the process of pursuing treatment? Will I write an advance care plan? Will I accept hospice if I have run out of available treatment options? Most of these questions have more than one correct answer, and the evidence for the superiority of one option over another is either not available or does not allow differentiation. Often the best choice between two or more valid approaches depends on how individuals value their respective risks and benefits; “preference-based medicine” may be more important than “evidence-based medicine.” There are various models for eliciting preferences, but applying them can raise a number of challenges.Objectives: To present the concepts, the value, the strategies, the quandaries, and the potential pitfalls of Shared Decision Making in Oncology and Palliative Care.Method: Narrative review.Results: Some challenges to practicing preference-based medicine in oncology and palliative care include: some patients don’t want to participate in shared decision making (SDM); the whole situation needs to be addressed, not just part of it; but are some topics out of bounds? Cognitive biases apply as much in SDM as any other human decision making, affecting the choice; how numerically equivalent data are framed can also affect the outcome; conducting SDM is also important at the end of life.Conclusions: By being aware of the potential pitfalls with SDM, clinicians are more able to facilitate the discussion so that the patients’ choices truly reflect their informed preferences, at a time when stakes and emotions are high.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"147 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116951902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Noncommunicable diseases (NCDs) pose the greatest problem for the health of nations in the 21st century. They are primarily cardiovascular diseases, cancers, chronic respiratory diseases, obesity and diabetes, and contribute to almost two-thirds of all deaths worldwide. The cost both in terms of human suffering and money is enormous for diseases, which are largely preventable. If the major risk factors for noncommunicable diseases were eliminated, around three-quarters of heart disease, stroke, and type 2 diabetes and 40% of cancer would be prevented.
{"title":"NEW DELHI DECLARATION 2018 ON PERSON-CENTERED CARE FOR NONCOMMUNICABLE DISEASES","authors":"J. Mezzich","doi":"10.5750/ijpcm.v8i3.887","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i3.887","url":null,"abstract":"Noncommunicable diseases (NCDs) pose the greatest problem for the health of nations in the 21st century. They are primarily cardiovascular diseases, cancers, chronic respiratory diseases, obesity and diabetes, and contribute to almost two-thirds of all deaths worldwide. The cost both in terms of human suffering and money is enormous for diseases, which are largely preventable. If the major risk factors for noncommunicable diseases were eliminated, around three-quarters of heart disease, stroke, and type 2 diabetes and 40% of cancer would be prevented.","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134008873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This volume includes the second set of papers that comprise the Educational Program on Person-Centered Care of the International College of Person Centered Medicine (ICPCM). Person-centeredness is the foundation of the patient physician relationship, which is itself at the heart of medical practice and health care. This relationship is based on the dialogue between the patient as a person and the physician as a professional person, allowing trust to develop between these two individuals so
{"title":"ICPCM EDUCATIONAL PROGRAM ON PERSON-CENTERED CARE: COMMUNICATION, COMMON GROUND, DIAGNOSIS, AND ASSESSMENT","authors":"J. Appleyard, J. Mezzich","doi":"10.5750/ijpcm.v8i3.886","DOIUrl":"https://doi.org/10.5750/ijpcm.v8i3.886","url":null,"abstract":"This volume includes the second set of papers that comprise the Educational Program on Person-Centered Care of the International College of Person Centered Medicine (ICPCM). Person-centeredness is the foundation of the patient physician relationship, which is itself at the heart of medical practice and health care. This relationship is based on the dialogue between the patient as a person and the physician as a professional person, allowing trust to develop between these two individuals so","PeriodicalId":402902,"journal":{"name":"the International Journal of Person-Centered Medicine","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126829214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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