000-Generic

Non pharmacological management is asked routinely in the KFP so learn this list.

Note that looking up something in eTG, asking a colleague GP, phoning a tertiary hospital registrar/specialist or asking your MDO for advice are all valid not pharmacological management. If you don’t know ask somebody who does know.

  • E – Education
  • S4 – Syptomatic, Supportive, Specific, Secondary Prevention
  • V – Vaccination
  • S4 – Screening – Routine, Associated, Family, Contact
  • A3 – Activities – sex/exercise, atmospheric pressure, post-seizure
  • R3 – Referal – Allied/Specialist, Rehab,  Social Support
  • A5 – Admin – paperwork, driving, public health, care plan, document
  • S3 – Saftety netting – review PRN, suicide/safety risk, safeguarding
  1. Education
  2. Symtomatic management
  3. Supportive management
  4. Specific management
  5. Secondary prevention
  6. Vaccination
  7. Screening – Routine
  8. Screening – Associated conditions
  9. Screening – Family screening
  10. Screening – Contact screening
  11. Activities – atmospheric pressure
  12. Activities – sport/exercise/concussion
  13. Activities – post seizure
  14. Referral – Allied/Specialist
  15. Referral – Rehabilitation
  16. Referral – Social support
  17. Administrative – paperwork
  18. Administrative – public health
  19. Administrative – driving restrictions
  20. Administrative – care plan
  21. Administrative – document advice given
  22. Safety Netting – review PRN
  23. Safety Netting – suicide/safety risk
  24. Safety Netting – safeguarding vs confidentiality

In more detail

  1. Education
    1. About the medical condition
    2. Support groups ie coeliac
    3. DM (+/- SGLT2) and DKA
    4. Inhalers and technique
  2. Symtomatic management
    1. RICE (Rest, Ice, Compression, Elevation)
    2. Simple Analgesia
    3. Cold
    4. Heat
    5. TENS
    6. Soft foods for sore throats
    7. Emolliants for itchy rashes
    8. Short fingernails for itchy rashes
    9. Exercise (MS)
    10. Nil by mouth and NGT
  3. Supportive management
    1. Psychological
    2. Fluids
    3. Nutrition
    4. Vapouriser
    5. Rest
    6. Regular sleep
    7. Exercise
    8. Ergonomics
    9. Relaxation (mindfullness, meditation, yoga, breathing)
    10. Delerium prevention in elderly
      1. Adequate hydration and nutrition
      2. Adequate pain relief
      3. Adequate sleep
      4. Correction of visual and hearing impairments
      5. Lighting appropriate to time of day
      6. Quiet
      7. Single rooms
      8. Clock and Calendar
      9. Family involvement
      10. Avoidance of restraints
    11. Falls reduction strategies
  4. Specific management
    1. Weight loss ie T2DM, OA
    2. Exercise
      1. Land based ie Walking, Tai Chi
      2. Water based ie Hydrotherapy
    3. Orthotics ie heel raise
    4. Splints
    5. Crutches
    6. Braces
    7. Walking stick/frame
    8. Home modifications
    9. Intermittent compression devices (DVT prophylaxis)
    10. Lubricating eye drops
    11. Artificial saliva
    12. Deactivate ICD in palliative patients
  5. Secondary prevention
    1. SNAP-O
      1. Stop smoking (if smoker with COPD)
      2. Mediterranean diet
      3. Limit alcohol intake
      4. Physical exercise 150 min/week
      5. Obesity -> Lose weight
        1. MDT of dietician, exercise physiologist, psychologist
        2. Bariatric Surgery
    2. Folate + Iodine (pregnancy)
    3. Thiamine (alcohol excess)
    4. Aspirin
    5. ACE
    6. Statins
    7. DOAC (AF, VTE)
    8. Bisphosphenates, Denosumab, Vit D, Calcium (Osteoporosis)
    9. HFrEF – ACE/ARB, Beta Blockers, MRAs, Sacubitril/Valsartan, SGLT2, Diuretics, Digoxin
    10. Falls prevention
    11. S.aureaus decolonisation with
      1. Mupirocin (Bactroban) 2% ointment nasal BD for 5/7 +
      2. Chlorhexidine 2% body wash OD for 5/7 and/or
      3. Bleach baths (60ml per tub) ) OD for 5/7
      4. Also sanitise clothes and linen
  6. Vaccination
    1. influenza
    2. pneumococcal
    3. zoster
    4. tetanus (dTpa)
  7. Screening – Routine
    1. ATSI
    2. Breast
    3. Cardiovascular
    4. Cervical
    5. CKD
    6. Colon
    7. Diabetes
    8. Osteoporosis
    9. Prostate
  8. Screening – Associated conditions
    1. Mental health associated with new Dx of disease
    2. DEXA scan
    3. Neuropathy – B12 deficiency
    4. Coeliac – Iron, Calcium and Vitamin D, B12, Folate, Zn, Vitamins A D E K
    5. Autoimmune – Other autoimmune
  9. Screening – Family screening
    1. heamochromatosis
    2. hypercholesterolaemia
    3. coeliac
    4. BRCA1/2
  10. Screening – Contact screening
    1. chlamydia
    2. gonorrhoea
    3. syphilis
    4. HBV
    5. HCV
    6. HIV
  11. Activities – atmospheric pressure
    1. flying
    2. swimming
    3. diving
  12. Activities – sex/sport/exercise/pregnancy/concussion
    1. sexual activity (particularly STD)
    2. seat belt use in pregnancy – above/below bump
    3. contact sport post-concussion
    4. contact sport post EBV splenomegaly
    5. bed rest
  13. Activities – post seizure
    1. no driving
      1. Private 6 months (first) 12 months (recurrent)
      2. Commercial 5 years (first) 10 years (recurrent)
    2. no solo swimming
    3. no ladders
  14. Referral – Specialist
    1. Allied health
      1. Psychologist
      2. Physiotherapist
      3. Occupational Therapist
      4. Dietician
      5. Diabetes educator
      6. Speech therapist
      7. Optometry
      8. Orthotics
    2. Medical Specialist
    3. Genetic Counsellor
    4. Self Help
      1. This way up
    5. Headspace (12-25 year olds)
  15. Referral – Rehabilitation
    1. pulmonary
    2. cardiac
  16. Referral – Social support
    1. Aboriginal Health Worker
    2. Social worker
    3. Meals on wheels
    4. ACAT
    5. NDIS
    6. Disease specific groups
    7. Social Prescribing
      1. Men’s shed
      2. Walking groups
      3. Gardening groups
      4. Cooking lessons
      5. Lawn bowls
  17. Administrative – paperwork
    1. WCC
    2. Medical Certificate
    3. Centrelink
    4. Fitness to fly
    5. Opiod contract
    6. Authority to prescribe
  18. Administrative – public health
    1. Reporting
      1. AHPRA mandatory reporting of doctors
      2. Police mandatory reporting of child abuse
      3. Public health reporting of infectious disease
      4. (Un)fitness to drive
    2. Prevent transmission
      1. PPE for staff
      2. Masking in public (for infectious people)
      3. Isolation day care/school/work
      4. Not sharing utinsils/clothing/bedding
      5. Hand washing – particulary after gastro
      6. No school for 2 days after gastro
      7. No swimming pool for 2 weeks after gastro
  19. Administrative – driving restrictions
    1. private
    2. commercial
    3. licence cancellation
  20. Administrative – care plan
    1. Asthma management plan
    2. ASCIA Action plans
    3. Sick day plan
    4. Care Plan – GPMP (721) & TCA (723)
    5. ATSI Health Check booking (715)
    6. Webster pack
    7. HMR
    8. CTG (Closing the Gap enrollment)
    9. NDSS (National Diabetes Support Service enrollment)
    10. Advanced Care Planning
    11. Will
    12. Power of Attorney (financial)
    13. Enduring Guardian (health)
  21. Administrative – document advice given
    1. Cover your ass
    2. Check with Prescription Shopping Program / Smart Script etc
    3. Set reminders for follow up
  22. Safety Netting
    1. Review if
      1. A B C happens…
      2. A B C does not happen…
      3. Mandatory review in X days
    2. Risk assessment
      1. Risk to Self: intentional or accidental through self-neglect or risky behaviours
      2. Risk to Others: intentional or accidental 
      3. Risk from Others: due to vulnerability, neglect or abuse
    3. Safeguarding vs Confidentiality
      1. Sexual abuse
      2. Child abuse
      3. Suicide/Homicide risk
    4. Epipen for anaphylaxis
    5. Lifeline phone number for depression