New research into the number of people living with more than one chronic illness is a sharp reminder that a higher incidence of longevity does not mean the population is healthier.
Researchers who studied 1.75 million Scots suffering from a chronic health problem found almost one-quarter had two or more conditions.
This situation has been increasing as the number of people over the age of 75 in Scotland has risen. It is clear from the study by three professors of primary care at Glasgow and Dundee universities, however, that medical practice has yet to adapt to the needs of the growing number of patients suffering from two or more conditions at the same time.
That must be regarded as a serious failing. Despite the difficulties such people face daily, they have to make multiple trips to doctors and hospitals because the NHS is set up to deal with each ailment separately.
More alarmingly, a failure to collaborate between specialists in hospital and with general practitioners and primary care teams means that one treatment may adversely affect another. This is not only a problem for older people. Although suffering from multiple conditions is more prevalent in those over 65, people living in deprived areas were likely to have more than one health problem at a younger age and between 10 and 15 years before those in affluent areas.
In particular, the survey found those in deprived areas were more likely to have a combination of both physical and mental disorders. In such circumstances, especially when drugs are prescribed to control mood or psychiatric illness, the need to ensure other treatment does not cause an adverse reaction is obvious.
GPs, community psychiatric nurses and district nurses are left to cope with this complex array of problems. That gives substance to the case for GPs in deprived areas to have lower numbers of patients. But that would apply a traditional medical model to a changing need.
A more radical approach, focused on co-ordinated medical care, may be the more effective prescription, especially when NHS budgets are under growing pressure and finite resources must be put to optimum use.
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