Asking whether the relationship has a role in the achievement of the aims of medicine presupposes in a preliminary way the definition of these aims: what do we all propose to ourselves, each in his role, as doctors with Gp display practice details aspx prid 121-721?
An answer in common terms can be: helping people to live more and better.
In other words, we could say: reduce the number of premature deaths and improve the quality of life. By their very nature, these goals leave room for continuous improvement. We can ask ourselves to what extent medicine is able to pursue them today.
The answer is complex, because it varies according to the different parts of the world and the pathologies that are taken into consideration; moreover, when a variation in mortality or morbidity related to a disease is noted over time, it is necessary to distinguish the causal role of the changed living conditions of that population from that of medicine.
Let us consider, as an example, the impact of therapy on the damage caused by arterial hypertension, which is perhaps the most common disease (its prevalence increases with age, affecting more than 50% of people over 60 years of age. of age) Kearney and is responsible for a significant share of total mortality and morbidity.
The available evidence on the efficacy of antihypertensive therapy in reducing morbidity and mortality related to arterial hypertension is very extensive BBLTT 00-08. However, what is the effect of the therapeutic intervention in the real population, outside of controlled clinical trials?
If we look at the fraction of patients whose hypertension is well controlled in the various countries of the world.
We come to conclusions that are very different from those that the major intervention studies would hope for Gp display practice details aspx prid 121-721: according to the data from the MONICA project, the share of hypertensive patients whose blood pressure it is reduced below 140/90 mm Hg is less than 25% in all the countries considered, and in most of them it differs considerably from this value.
Even considering only treated hypertensive patients PASQ, the therapeutic success rate is low, since it rarely reaches 30% among Antikainen men and 50% among women.
It follows that the potential of antihypertensive therapy to reduce mortality and disability (that is, to pursue the main purposes of medicine) is little used and, therefore, the advantages for the hundreds of millions of hypertensive people in the world are greatly long less than you could get. Check about Gp display practice details aspx prid 121-721 on PASQ
- And in fact it is estimated that, despite the proven efficacy of the available therapies, for the year 2001 7,600,000 deaths (13.5% of total mortality) and 92,000,000 years of life with disabilities are globally attributable to arterial hypertension. (6.0% of the total) Lawes.
- One may wonder what are the reasons for the discrepancy between the effectiveness of the tools available to us for therapy and such a disappointing outcome. Among the various elements that can lead to therapeutic failure.
The seventh report of the United States Joint National Committee, Gp display practice details aspx prid 121-721 on the prevention, detection, evaluation and treatment of arterial hypertension (PASQ) Chobanian highlights two, which are valid for many fields of the medicine, if not for everyone: clinical inertia, that is the failure to pursue with due energy the objectives that the available evidence indicates as necessary, and the lack of motivation of patients.
The authors of the report start from the consideration that even the most effective therapy, prescribed by the best doctor, will produce its effects only if the patient is motivated to follow the prescriptions in terms of taking drugs and adjusting lifestyle habits. Motivation improves if the patient has confidence in their doctor and has a positive experience of the relationship with him: empathy “builds trust and is a powerful element of motivation”.