Richard Smith on a chance to collaborate on a book on complex chronic disease

Richard SmithWould you like to contribute to a book on complex chronic disease? The book has been written for the Spanish government, which currently has the presidency of the European Union and wants to draw attention to the importance of complex chronic disease.

You probably don’t recognise the term “complex chronic disease,” but it’s actually the main concern of doctors and health systems. Patients with “complex chronic disease” are patients who have multiple chronic diseases (cardiovascular disease, diabetes, chronic obstructive pulmonary disorder, cancer, depression, osteoarthritis, and any long term condition) perhaps with complications and certainly with psychological and social components.

In the classic medical model patients present with single diseases, are diagnosed, treated, and cured. This is ever less of health care, and yet it continues to be the dominant way of thinking. A tour around any hospital will show that few patients have single, curable conditions and that most have complex chronic disease. Patients with complex chronic disease account for most visits to general practitioners, most hospital admissions, and a huge proportion of health care costs.

So the first reason you might like to contribute to this book is that it will deepen your understanding of complex chronic disease.

The second reason is that you can probably improve the book. We, the authors of the book, very much believe in the “wisdom of the many rather than the few.”  James Surowiecki in “The Wisdom of Crowds,” Charles Leadbeater in “We-think,” and Clay Shirky in “Here Comes Everybody” all describe cases where the many have been able to do what the few could not. (This is a good reading list for those who want to explore further the power of the many unleashed by the internet.)

A third reason for you to contribute is that you might enjoy being part of an experiment. As far as I know, few if any medical books have been written in this way.

A final reason is that if you make an important contribution to the book we will include you as an author. Perhaps you need to boost your CV. Another selfish but far from ignoble reason is that you might be invited to the launch of the book in Seville (and possibly the Basque country as well) in June.

If you want to contribute—or just read the book—you should go to:

You should click on the chapter where you would like you to contribute, and I urge you to start either with the introduction or the chapter on prevention, which I have written with colleagues. You can read the chapters in either English or Spanish and contribute in either language. You add your contribution in a comment box that is attached to each section of the chapters.

We, the authors and editors, will read all the comments and revise the chapters and allocate authorship accordingly. I hope that you will contribute, and I hope that I may bump into you in Seville, where I’ll be happy to buy you a glass of Rioja (even if it turns out that there are thousands of you.)

Competing interest: I’m an author of one of the chapters in the book but was not paid, and I’ll have to pay my own way to Seville and for your glass of Rioja.

  • Jackson

    What sort of comments are you looking for? Editorial? Medical facts and contributions?

  • Richard Smith

    We’re looking for any kind of comment, but we will be more interested in comments on content rather than style.

  • Nnodimele Atulomah

    Richard, wonderful; I will love to be part of this. My area of special interest is in adherence challenges for patients undergoing treatment for chronic illnesses particularly, hypertension in Nigeria. I was at the recently concluded Writing Skill training workshop you facilitated in Abuja.

  • Kolade Austin Giwa

    Hello Richard, I am sure am gonna love this.Where do you belong? That Chronic illnesses like diabetes are inherited or as a result of environmental influences. If its a spectrum of both inheritance and environmental, which of the two plays a greater role in determining the outcome?

  • Gnanie Panch

    Chronic pain is invariably associated with distress, poor quality in life and dissatisfaction with services. Psychological therapies are incorporated to address the emotional factors in pain services. Evidence for the effectiveness of psychological interventions alone, to treat depression that is a common co-morbidity, is unclear.

    A prospective audit of services has shown that major depression is not uncommon at their presentation. Measurement of chronic pain based on gold standard recommendations, “Immpact”, indicate a high prevalence of undetected depression among chronic pain sufferers. There is evidence that the treatment based on NICE CG 23 recommendations improve patient’s functioning. I will be pleased to describe an approach in management.