Tool to assess the biopsychosocial vulnerability of complex patients in primary care
The Biopsychosocial Vulnerability in Primary CarePizzini A, Marrocco W, D’Ingianna AP and Marri G - J Health Science 2017. 5(4); DOI:10.17265/2328-7136/2017.04.001
The aging of the population and the consequent progressive increase in the prevalence of chronic diseases requires careful reflection on the way in which clinical guidelines are developed and applied.
An age above 65 years is characterized by comorbidity, defined as the concomitant presence of two or more diseases in the same subject. In fact, it has been estimated that the majority of people between 65 and 79 years have 4.9 diseases, while in those over 80 years the number of diseases rises to 5.4.
It is easy to imagine how all these problems affect the daily work of MDs working as GPs. GPs must aim at an epochal change in the way of approaching chronic diseases in the population of its territory. The relationship between doctor and patient is a personalized model that must be maintained and implemented through a series of prevention interventions, early diagnosis and rational therapy.
To achieve this, the GP needs to investigate and evaluate tools to determine the biopsychosocial vulnerability and the creation of a flow-chart for the establishment of health and socio-personalized care programs, but based on scientific evidence. In this study a group of Italian GPs (S.I.M.P.e S.V. Italian Soc. of Preventive Medicine and Life Style) have tested, on a cohort of complex patients, this tool built as an original scale of assessment for general medicine, which could simultaneously analyze the Bio-Psycho-Social aspects of patients.
In conclusion, with this assessment scale they have been built a general medicine instrument, simple, integrated with primary care setting and tools, fast in use. In the research and validation phase has been showed how this scale would be able to identify patients in need of more attention where there is a necessity to go from a Guideline and EBM-Based approach to a Personalized approach.
A contribution by: Walter Marrocco - Scientific Manager of F.I.M.M.G. (It. Fed.of GPs)