Books: Living Well with Long Term Conditions. Getting Involved in The Decisions That Matter to You The Most

Living Well with Long Term Conditions was written by Dr Gayathri Dittakavi during her GP training. Dittakavi must be commended on her enthusiasm to write a book devoted to facilitating patient education and understanding of their chronic condition.

Dittakavi dedicated the first section of the book to descriptions of a range of chronic conditions. The information is brief and not overbearing. The use of diagrams, subtitles, and colour is visually appealing. Explanations of medical terminology aim to improve patient knowledge. For example, ‘ischaemic stroke, when a blood clot blocks the flow of blood and oxygen to the brain’. Contrarily, the opposite effect may be apparent where terminology is not depicted — ‘family history of aneurysms’. I felt that edits were required for some disease descriptions, including: ‘CKD means gradually worsening kidney disease that does not go away’. This may have been better portrayed as ‘a long-term condition where the kidneys work less well than they should’.

Dittakavi laudably moves to emphasise lifestyle management, encouraging patient engagement. A motivational interviewing approach is employed throughout this section to address modifiable risk factors of disease, interspersed with practical suggestions to minimise/improve morbidity. I felt this section could be improved in areas through closer alignment with National Institute for Health and Care Excellence guidance to strengthen the evidence base.

The penultimate sections focus on social care, end-of-life care, and legal aspects. These bestow an overview of the moral, ethical, and legal considerations and complexities of disease management, including advanced care planning. For patients, this is a useful introduction to this subject area. However, further face-to-face patient-clinician consultations are essential to discuss, clarify, and provide current guidance.

Lastly, Dittakavi provides an ‘Everything Else’ section, which includes use of technology and alternative therapies. These are subjects that matter to patients and may not otherwise be considered by their clinician within a short consultation. This information could act as prompts to direct patient-clinician discussion. Other subjects contemplated by my own patients, which could be included in a future version, includes body bequeath, medical research, and clinical trials.

Overall, I feel that consideration to the descriptions and explanations provided within the book are required to strengthen and improve accuracy within the book. However, Living Well with Long Term Conditions is a useful guide, which could be used as a starting point for health professional consultations.

• © British Journal of General Practice 2020