Chronicity

This book comprehensively and critically discusses chronicity as a crucial challenge for the future of medicine in an era of aging populations and the steady growth of non-communicable comorbidities. It describes how health systems that are still designed and based on the treatment of acute diseases are suffering from crowded emergency rooms and growing conflicts between patients, while medical staff increasingly face frustration and the risk of burn-out.

The author not only shares her own clinical and personal experience in the care of end stage COPD or ALS patients with respiratory insufficiency, but also explores how primary care, incremental medicine and initiative medicine can improve the care provided for these patients. In turn, the book examines how developing countries are facing the chronicity issue in their daily struggles with communicable diseases like diarrhea and infections, and with non-communicable ones like obesity, diabetes and asthma. It also discusses the cost-related challenges that could accompany a possible paradigm shift from chronic to curable status, as was the case with hepatitis C. Due to the inevitable link between chronicity and end of life, the author tactfully addresses palliative care, focusing on the importance of shared decision-making as well as a full awareness of the future scenarios.

Uniquely reflecting life-long clinical experience and stimulating discussion on a highly topical issue, this book appeals to a wide readership, from health professionals through caregivers to patients with chronic conditions.

• non communicable disease
• comorbities
• palliative care
• end of life
• end of life care
• health care burnout
• ageing population
• incremental medicine
• primary care
• initiative medicine

• Specialist in Pulmonary Medicine and Allergology, Hospital San Camillo Forlanini, Private Praxis, Rome, Italy

  Dagmar Rinnenburger

Dagmar Rinnenburger is a German Physician, living in Rome since 30 years, specialised in pulmonary medicine and allergology with a long experience in german and then Italian hospitals in the field of pulmonary medicine. She worked in respiratory rehabilitation and patient education and then in pulmonary intensive care in the San Camillo Hospital, one of the largest hospitals in Rome. In particular, she has treated patients with respiratory insufficiency caused by neuromuscular problems such as amytrophic lateral sclerosis or end stage COPD. Her particular attention was given to shared decision making in end stage settings and she has always been interested in the improvement of communication between patient and doctor. She teaches as a guest professor in the Unicamillus Medical School and tries to focus on chronicity in the first years of medical education.

Policies and ethics