Comorbidity is defined by the coexistence of two or more chronic diseases in the same person. Chronic disease pathology is understood that persistently prevailing in time, no option but with healing stabilization option. Thus, the progressive aging of the population is accompanied by a high prevalence of patients pluripatológicos. In fact, it is estimated that by 2050, 27% of the population in Spain are people with chronicity.
The pluripatológico patient usually corresponds to a profile of fragility with functional dependence and / or cognitive likely outcome with high use of health care resources (hospital, geriatric or residence) and high mortality. For this reason, the figure of the doctor geriatrician is essential for the clinical management of the patient pluripatológico, with the aim of coordinating the intervention of different specialists and ensure a comprehensive view of the person to ensure their health and quality of life.
Pluripatológico chronic disease patient
The main pathologies of chronic patients are:
a) Heart disease: cardiovascular risk factors such as hypertension, diabetes, cholesterol or favor the onset of these diseases. Ischemic heart disease and arrhythmias are the greatest exponents and its main manifestation is heart failure.
b) Respiratory diseases: Smoking is one of the main responsible for this group of diseases, represented mainly by chronic bronchitis.
c) Neurological diseases: Dementia is one of the characteristics of the geriatric population degenerative diseases, not to mention the aftermath of stroke or Parkinson 's .
d) oncological diseases: In a high percentage of cases, the cancer has gone from being a deadly chronic disease.
They are usually interrelated diseases among them, which justifies the high risk of a cascade of decompensation before a breakthrough process as a respiratory or urinary infection, which can lead to a high probability of hospitalization.
The geriatrician is crucial for quality of life
The doctor-patient communication is always important, but in the case of the patient is essential pluripatológico. The patient should know their chronic diseases and the warning signs that may indicate a possible decompensation of it and immediately contact their physician regarding to optimize treatment.
If we talk about treatment for cases of multiple diseases, we will discuss the prescription of a large number of drugs needed for each of the different diseases affecting the patient. The internist or geriatrician be responsible for ensuring the reconciliation of all this medication as conditions of each patient, ensure adequate dose and avoid prescribing inappropriate medications or whose risk advice seek therapeutic alternatives.
Currently, the main Spanish hospitals are creating units to ensure patients pluripathologic expert handling of these patients from a multidisciplinary approach. That is, by integrating various professionals such as doctor, nurse, social worker and physiotherapist, in order to promote individualized and planned care with these highly vulnerable people.