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Prevention of disabilities linked to chronic diseases

World wide the global diseases burden has changed rapidly towards chronic conditions, while the majority of current health systems continue to provide cure and acute care rather than continuity of care. The near future will see even more dramatic changes in the health needs of the world population, with non-communicable diseases as the leading cause of disability.

The Council of Europe Committee of experts on the prevention of disabilities linked to chronic diseases (P-RR-PREV) is currently preparing proposals to Governments aimed at reducing disabilities caused by chronic diseases and in that context it is exchanging prevention policies presently in place in member states.

The Committee will draw up a report on the most appropriate means of prevention and prepare a draft resolution on that matter for the Committee on the Rehabilitation and integration of People with Disabilities (CD-P-RR) to be submitted to the Committee of Ministers of the Council of Europe.

For the purpose of that study, the term “chronic disease” is understood to mean any long-term state originating from a pathological process which remains active, with health (care-necessitating) and/or functional consequences, entailing changes to all or some of the aspects of personal life and/or life in society.

Although measures aimed at prevention of chronic diseases (primary prevention) and of the impairments that these might cause (secondary prevention) are indispensable in combating disabilities, this report focuses on the prevention of the disabilities deriving from these chronic diseases (tertiary prevention).

The Council of Europe Recommendation No. R (92) 6 on a coherent policy for people with disabilities stipulates that preventive action should be taken as early as possible to prevent an impairment from arising or worsening, to reduce as far as possible the degree of disability for a given impairment, and to reduce any social disadvantage arising from a given disability.

In addition to the measures to detect, diagnose and treat impairments at an early stage, steps should be taken to ensure individualised and community programmes of rehabilitation, including follow-up and evaluation, as well as the necessary support to individuals and their families . These programmes should take into account, inter alia, of each individual's specific situation and problems, with the help of functional diagnosis, in order to prevent any secondary (emotional, cognitive, mental, motor or social) effects of the impairment with the help of early educational measures targeted at the individual and the creation of awareness in the family and the sector of society concerned.

Along with the steps recommended to prevent impairment and/or disability, individualised programmes of psycho-social rehabilitation aiming at the full development of the person should be set up. In addition, all necessary and adequate (also binding) measures should be used, as well as adequate measures to provide information, so as to promote the full integration of people with disabilities into society, inter alia, by means of early integration at school, provision of adapted educational services, integration into ordinary working life, etc, to enable them to live an independent life.