Narrative medicine and the personalisation of treatment for elderly patients

多药 医学 叙述的 折旧 人口 叙述性探究 医学教育 重症监护医学 语言学 环境卫生 哲学
作者
Cristina Cenci
出处
期刊:European Journal of Internal Medicine [Elsevier BV]
卷期号:32: 22-25 被引量:18
标识
DOI:10.1016/j.ejim.2016.05.003
摘要

Healthcare organisations, medical knowledge and clinical practice are among the contexts that have most strongly felt the impact of the over 75 population. This is a population of multimorbidity and polypharmacy patients. They are often seen as a conglomeration of juxtaposed guidelines resulting in the intake of more than 10 drugs a day, with absolutely no certainty of their efficacy. The scientific community is increasingly calling into question the current disease-focused approach. Narrative medicine can provide the tools for a treatment plan which is instead more patient-centred. Narrative medicine can promote the development of a systemic, integrated and multi-disciplinary approach to elderly patients. The stories of patients and caregivers, their representations, perceptions, experiences and preferences can reduce the risk of inappropriate tests and treatments. They can promote deprescribing procedures based on a careful analysis of a specific patient's needs. Narration time is treatment time which does not necessarily create a burden on organisations and caregivers. Quite the contrary since by facilitating adherence and team work, it can significantly reduce time and costs. Given their training and the importance of their relationship with elderly patients, internists, together with geriatricians, can play a key role in promoting and coordinating a narrative medicine approach.

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