CARE PLAN template material. IBS.

GP MANAGEMENT PLAN
Patient problems / needs / relevant conditionsGoals – changes to be achieved (if possible)Required treatments and services including patient actionsArrangements for treatments/services (when, who, and contact details)
1. General
Irritable Bowel SyndromeIncrease patient’s understanding of condition.Patient education. Support. GP
Self-managementDevelop self-management routine.Assess patient’s way of self-monitoring: support, educate. Establish and maintain trigger avoidance routine. GP
Dietary management
establish and maintain dietary regimen for best management of IBSWork together with dietitian in order to establish and maintain dietary regimen for best management of IBS.GP, Dietitian
Psychological managementManage impact and psychological aspects of IBSAssess the need of the patient for psychological services. If needed, involve psychologist under GP MHP
awareness and discussion of the psycho-social factors that impact upon IBS 
symptoms
awareness and discussion of the role of talking therapies to reduce symptoms
of IBS
awareness and discussion of the relationship between anxiety / depression 
and IBS symptoms
GP, psychologist
“Red Flags”Exclude dangerous / underlying conditionsInvestigate any “red flags”. Explain all the possibilities to the patient. 
awareness of the possible differential diagnoses of IBS including 
inflammatory bowel disease, coeliac disease, and in women ovarian cancer
the arrangement of appropriate investigations relevant to the exclusion of 
serious differential diagnoses
GP
MedicationsMedications managementa. Assess need for medications. Support and explanation.b. Review medications in order to identify potential triggers of IBS symptoms
discussion and awareness of the indications and side effects
of drugs relevant to the pharmacological management of IBS
which include but are not limited to
antispasmodics
Mintec
Mebeverine
digestible fibre therapy
Fybogel 
Pain management therapy 
tricyclic antidepressants 
second line agents
selective serotonin receptor blockers
GP, Pharmacist
2. Lifestyle
Healthy lifestyleDevelop and maintain healthy lifestyle routineAssess lifestyle. Address healthy sleep routine, rest and work balance.GP
Weight
Your target:BMI ≤ 25Men waist ≤ 94 cmWomen waist ≤ 80 cmMonitorReview 6 monthlyPatient to monitorGP
Physical Activity

Your target:At least 30 minutes walking or equivalent 5 or more days per weekPatient exercise routine. Explain importance of exercise in management of IBS. Develop and maintain safe and effective exercise routine
Patient to implementGPPhysiotherapist
SmokingComplete cessationSmoking cessation strategy:Consider:- Quit- MedicationPatient to manageGP
Alcohol
Your target:≤      standard drinks per dayIdeal:≤ 2 standard drinks per day (men)≤ 1 standard drinks per day (women)Reduce alcohol intakePatient education
Patient to manageGP to monitor
3. Biomedical
Health check as per current guidelinesMaintain general healthAnnual check; BMI, cholesterol, BP, vit DGP

Copy of GP Management Plan offered to patient?  y

Copy / relevant parts of the GP Management Plan supplied to other providers?  y

GP Management Plan added to the patient’s records?  y

Date service was completed:  Proposed Review Date:  

I have explained the steps and any costs involved, and the patient has agreed to proceed with the plan. YES