1. Chronic illness in General Practice It is important to know about. Why? Because Chronic illness is a tough challenge to the patient and doctor. It has complex Effects ad side effects and requires long-term care

2. Chronic illness in General Practice It is the COMMONEST cause of death of people alive today So It has to be Managed. One of the major problems is that patients rarely understand It and what lies ahead. It is the Core of General Practice in the 20 century.

3. What we will discuss In regard to chronic illness : Nature Impact Facts and Models Role of screening Programmes

4. Chronic illness Nature They are often diseases of process or processes rather than disorders of structure. There is diffuseness of the disordered process in the tissue or system. Disordered process causes sign or symptoms. It cannot be removed through series of cuts

5. Chronic illness Nature Examples: Asthma complex inflammatory response in the airways. Hypertension over pressurizing of the arterial system that. Rheumatoid arthritis over reaction of the immune system that identifies the synovium not as a self but as a foreign.

6. Chronic illness impact It has a profound effect on patients life through Morbidity,disability, handicap, impairment, loss of confidence, and stigma The doctor has to understand how the illness is affecting the patient and how the patient sees the problem.

7. Chronic illness impact The doctor must explain to the patient the problem from the patients point of view and how to approach the problem. Patients feelings is an important prospective,sometimes the feel isolated because family and friends cannot understand what it is like to have the illness.

8. Facts and models Chronic illness is relatively common based on results of 3 organizations in the UK: 1-General house hold survey,witch is conducted by office for national statistics and is reported annually. 2-National morbidity survey in general practice (NMSGP) 3-Epidemilogical data on chronic illness comes from specific epidemiological studies (carried out in distinct population).

9. Screening and Surveillance. Screening should be Specific ( to ensure that the number of false positives is manageable), and sensitive enough to give confidence that most actual cases are detected. Disease or Risk Factor should be amenable to prevention or treatment.

10. Screening and Surveillance. There are two types of screening: 1-Population screening :offered to the whole population being screened. 2-Opportunistic screening :the test is offered to members of the group to be screened who happen to attend to a specific reason.

11. Screening and Surveillance. A problem Most chronic illnesses cannot be detected by screening because there is not a screening test for the disease which is specific and sensitive enough.

12. Programming The programme should be for the long-term management of the chronic illness. There should be an agreement on the management plan. The patient should be asked what he expects from the primary care team and what the primary team expects for him.

13. Programming How to deliver the programme ? Advertisement : The patient should be informed of the service. Organization. Clinical leadership: By doctors and nurses together or each alone. Clinical care: provided also by one of the doctors or a team.

14. Programming Administration : Who will be responsible for maintenance of the disease and prescription registers. Other clinical help provider as a dietician.

15. Summary Chronic illness is a major element of most areas of clinical medicine. Chronic illness is often detected or diagnosed late so under treated. Its impact is complex. Screening is essential in particular types as hypertension and diabetes. A programme is required for the long-term management of all chronic illnesses.

16. DONE BY DR.RAYAN ALSHAREEF DR.MOHAMMED MOUSA DR.HATIM ALMARZOUKI