4 MIN READ

Surgeries and comorbidity: are there apps for that?

In the past year my family and I have had a total of six surgeries. I’m happy to say this was an extraordinary year for us and the surgeries ranged from minor (setting the bone in my daughter’s little finger) to life-saving (for the treatment of hydrocephalus and replacing a ventriculoperitoneal shunt – it was the third shunt to be placed).

Personally, I’ve had two surgeries this year along with all the extra testing involved. I am lucky. I had outstanding, professional, timely care. But where I did struggle was receiving conflicting information after my surgeries.

I like to think of myself as a fairly well-informed, engaged patient. Upon completion of my second surgery, my surgeon stated that I should stop the follow up pharmaceutical treatments. OK – she mentioned one, but what about all the other medications?

I called my GP the following day for advice and he wasn’t sure what to do either. Was his best advice better than my gut instincts? Probably – but as my GP stated, none of this was an exact science. The inexactness of my situation was further supported by my next office visit where I received contradictory instructions again.

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I’m thankful my situation was short-lived. But it got me thinking about all of the people with comorbidity. How do they manage all of their prescriptions, especially considering they might be coming from different specialists? I know time is money and the amount of time given to a patient is closely monitored.

My father’s paper medical file from the past two years is over a foot thick (I’ve seen it hauled around in his doctor’s office). How can the average patient manage their medication? How can we keep up with all of the fantastic new medical choices? We’re always looking at ways to improve patient adherence but just thinking about managing multiple treatments makes me really empathise with patients and their carers.

People are living longer and there are more treatments available. This is creating more demand on primary carers. A recently published article in the BMJ on Managing patients with multimorbidity in primary care had three main points: doctors’ practices should actively identify patients with complex multimorbidity (and their conditions); adopt a policy of continuity of care with one identified physician; and ‘specific extended consultations’ should be assigned protecting the time with the patient.

Appointments range from 48 seconds in Bangladesh to 22.5 minutes in Sweden. In the U.S., meetings with doctors average about 20 minutes. The pressure to see patients means that manging the care will fall back onto the patients. Many see this as an area where apps can help.

In a recent paper published in the NCBI JMIR Mhealth identified 272 medication reminder apps. Of those only 33 were available in Google Play and iTunes. Parkinson’s News Today recommended 6 apps to manage chronic health issues. But these were six different apps all offering support for only one aspect of manging the condition. Medisafe is an app that manages medication. The main features are reminders for taking the medication, possible drug interactions and refill reminders.

This does seem like it would help, but with each app only offering partial management I wonder if there will soon be an app to manage the apps…

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