Dismantling ableism in health professions education: imperative in psychosocial management of pain.
Authors: Van Der Laan KF, Spector AL
Journal: Frontiers in public health
mental health
psychology
open access
Abstract
People with multiple long‐term conditions (MLTC), increasing with an aging population, are at risk of poor health outcomes and treatment burden. MLTC, also described as multimorbidity, are defined as having two or more chronic conditions []. People with MLTC are at increased risk of poor quality of life [] and common mental health problems such as depression [] and anxiety []. Yet common mental health problems are poorly diagnosed in people with MLTC [, ]. In addition, an increasing number of chronic conditions are associated with poorer health outcomes and increased complexity in people with MLTC [, ]. People with MLTC are also at increased risk of treatment burden, many visits to different healthcare providers, and polypharmacy []. Polypharmacy is commonly defined as having ≥ 5 prescriptions [], and is associated with increased risks of drug–drug interactions, adverse drug reactions, and potentially inappropriate prescribing [, ]. Potentially inappropriate prescribing is when prescribing does not follow current medical guidelines [] and leads to higher risks than benefits for the individual [, ]. Medication can be potentially inappropriate if it has higher risks than benefits for an individual regardless of dose or period of intake of the medication [], or if medication is prescribed for longer time periods or in higher doses than recommended []. One example of potentially inappropriate medications is benzodiazepines [, ]. Benzodiazepines have been used in short‐term treatment of insomnia and anxiety, but are no longer recommended in any dose or for any time period in Sweden since 2016 []. This is due to lack of treatment effect over time [], and risks of adverse drug reactions involving addiction [], falling [], and cognitive impairment [] when used long‐term. Nevertheless, there are a few exceptions when benzodiazepines still have an indication such as in individuals with epilepsy [] and for shorter periods of severe behavioral and psychological symptoms in dementia [].