October 11, 2024

Therapy – DocCheck Flexikon

from Greek: θεραπεία (“therapeia”) – serving, serving, nursing
Synonyms: Treatment
English: therapy

Therapy is the treatment of a disease in the broadest sense. Various concepts can be used, which aim either to eliminate the cause of the disease (causal therapy) or to eliminate the symptoms (symptomatic therapy). The overarching goal of the therapy is to restore the normal physical and mental functions of the patient as completely as possible.

The practitioner who carries out a therapy is called a therapist.

The most important prerequisite for the effectiveness of therapy is the correct diagnosis of the disease to be treated. Only from it results the indication for treatment. In addition, it must be taken into account whether the patient has already been treated for his illness or is therapy-naïve.

Before starting therapy – especially in the case of interventions in body integrity – the consent of the patient must be obtained. For this purpose, the patient must be aware of the dangers and possible negative consequences of the therapy and agree on this basis formally, i.e. in writing.

Under certain circumstances, therapeutic measures may also be prohibited, for example, if the patient’s diagnosis is infaust and further treatment measures are pointless, or the patient has excluded certain therapies by means of a living will.

A more frequently used, systematic therapy is called a therapy method. For a few diseases there is only one treatment option, for most different therapy options. However, after consultation with the patient against the background of the anamnesis, the practitioner usually only decides on a specific therapy concept.

Complex therapies, which consist of several individual measures, are laid down in a therapy plan. If they follow a certain, predefined process, one also speaks of a therapy scheme. In evidence-based medicine, these schemes are usually documented in a guideline. The preferred, first treatment option is called first-line therapy. If this treatment fails, second-line therapy or third-line therapy is used escalatingly.

Treatment can be undertaken in one or more therapy sessions. In addition to the content planning of the treatment, the therapy costs must also be taken into account. In some cases, it may be useful to critically review the necessity of a therapy that has already begun. One way to do this is to try it out.

One can schematize the concept of therapy on the basis of different concepts. First of all, one can distinguish into:

  • general or non-specific therapy: is based on the overall condition of the patient and is aimed at the general promotion of healing
  • special or specific therapy: goes into concrete details of the disease or cure

Further differentiation possibilities arise… according to the goal of therapy

  • Causal therapy: Is directed to the cause of the disease
  • Symptomatic therapy: relieves symptoms without eliminating the cause
  • Curative therapy: Aims at healing
  • Palliative therapy: Does not want to achieve a cure, treatment but to improve the quality of life.
  • Adjuvant therapy: support of the main therapy
  • Neoadjuvant therapy: improvement of the initial situation before the main therapy
  • Cytoreductive therapy: reduction of tumor cells
  • Adaptive therapy: adaptation of the therapy to the individual body reactions
  • Preventive therapy: prevention of diseases as a goal
  • Supportive therapy: Supports treatment, e.g. by eliminating accompanying symptoms
  • Induction therapy: initial treatment that should achieve rapid therapeutic success
  • Maintenance therapy: long-term therapy to ensure the success of treatment

… by duration of therapy

  • Short-term therapy
  • Long-term therapy
  • Long-term therapy

… according to the focus of therapy

  • Topical therapy or local therapy: limited to the actual site of the disease (e.g. ointment for eczema)
  • Systemic therapy: Targets the entire organism (e.g. parenteral antibiotics)

… by subject area

  • Internal therapy
  • oncological therapy
  • and so on.

… by number of patients

  • Individual therapy
  • Couples therapy
  • Group therapy

… according to the appropriateness of the therapy

  • Over-therapy
  • Undertherapy

… by mode of therapy

  • Acute therapy: Rapid treatment of a life-threatening health disorder
  • Wait-and-see therapy: treatment that initially focuses on observing the course of the disease
  • Aggressive therapy: treatment that accepts side effects
  • Invasive therapy: treatment that enters the body in violation of tissue integrity
  • Non-invasive or minimally invasive therapy: Treatment that leaves tissue integrity intact or spares.
  • Stand-by therapy: immediate intervention in the event of acute illness
  • Low-dose therapy: therapy with low doses (drugs, radiation)

… according to therapy algorithm

  • Step-by-step therapy: therapy that is systematically based on the severity of the disease
    • Step-up therapy: start at the currently necessary stage and escalation if necessary
    • Step-down therapy: Start above the presumably necessary stage and de-escalation when control is achieved.
  • Sequence therapy: treatment measures in a certain sequence

… by techniques of therapySurgical therapy

Surgical therapy is based on targeted manipulation and, if necessary, replacement of defective body structures. Conservative therapy

Conservative forms of therapy want to cure the disease without surgery. These include, but are not limited to:

  • Drug therapy or pharmacotherapy: administration of medication
    • Monotherapy: Administration of an active ingredient
    • Combination therapy: administration of a combination of active ingredients
      • Triple Therapy
      • Augmentation therapy
    • Antiretroviral therapy
    • CAR T-cell therapy
    • Chemotherapy
  • Radiotherapy
  • Photodynamic therapy
  • Psychotherapy
    • Gestalt therapy
  • Behavioral therapy
    • Confrontation therapy
  • Phytotherapy
  • Physiotherapy
    • Exercise therapy
    • Light therapy
    • Hydrotherapy
    • Cryotherapy
    • Balneotherapy
    • Electrotherapy
  • Dietary therapies
  • Artistic therapies
    • Art therapy
    • Music therapy
    • Dance therapy
  • Manual therapy

One speaks of therapy resistance when the illness of a patient responds unsatisfactory or not at all to the medically indicated treatment, although in the normal case an improvement or cure should have occurred. If the curative treatment options of a disease are exhausted and there are no more meaningful treatment options, the patient is referred to as “exhausted all other forms of therapy”. Further treatment is then palliative.