Title Chronic PCM ✅

P: patient education L: lifestyle I: investigation M: management/medication A: appointment/ TCA S: safety netting If q sheet xde any result of IX → hint to send IX in MX ( explain to pt what ix need to be done and will review in the next TCA) --------------------------------------------------------------------------------------------------------------------------- Chronic → DM, HPT, Dyslipidemia, Metabolic syndrome METABOLIC SYNDROME Clusters of heart attack risk factors Waist circumference : M (>90cm), F (>80cm) or BMI >30 HX - Greet patient (proper title) + introduce self + confirm pts details (name, age, occupation) - Put pts in ease (if in pain→ need PCM?) - Elicit reason pts attendance with open-ended Qs (what brings you here) + maintain eye contact Iman, Nisa, Izzaty (23/2/2021) Forti


2. Physical activity FITT criteria should be considered F: Frequency I: Intensity T: Time (duration) T: Type of exercise 3. Behaviour Therapy ● Counselling: Eating practice, physical activity habit & emotional response to weight ● Self monitoring: Keep daily records of PA, food intake & problems ● Portion control ● Stress management ● Smoking cessation ● Weight loss support groups 3.Investigations ● OGTT to confirm T2DM ● Fasting lipid profile ● RP ● LFT ● Urinalysis ● Baseline ECG 4.Pharmacologica l management Indications Pharmacotherapy can be considered for patients with T2DM with BMI ≥27.0 kg/m2 after failing 6 months of lifestyle modification ● BMI between 25 and 27.5 kg/m2, and at least two of the following • diabetes mellitus • Coronary heart disease • Cerebrovascular disease • Hypertension • Hyperlipidaemia • Waist circumference >90 cm for men, >80 cm for women ● BMI ≥27.5 kg/m2 ● Symptomatic complications of obesity such as severe OA, obstructive sleep apnoea,reflux oesophagitis, and the compartment syndrome Iman, Nisa, Izzaty (23/2/2021) Forti