Articles
What is Patient-centred care? (2)
- August 30, 2021
- Posted by: mghalandari
- Category: Definition Digital health
The most effective self-management education programs are those that are longer, more intensive and well-integrated into the health system, and in which the learning is reinforced by health professionals during regular followup care. Eff orts should be focused on providing opportunities for patients to develop practical skills and the confidence to self-manage their health. Handson participative learning styles are better than traditional didactic teaching.
Patient-centred telecare (providing people with information, health coaching using motivational techniques, advice and support over the phone to their homes) can reduce social isolation. It can also improve people’s confidence and ability to cope, reduce depression and improve quality of life.
When it replaces routine personal home visits or clinic visits it can save costs. Sharing personal medical information and encouraging people to review their records and the advice they have been given can be very empowering.
Giving patients access to personal medical records has been shown to increase their sense of control, but few other benefits have been proved. Providing audiotape records of consultations improves patients’ knowledge and recall.
There are few systematic studies on the benefits of self-help groups, peer support and other community development approaches. Such evidence as there is shows people welcome this type of social support, gain knowledge and improve their coping abilities. But there is little evidence of a lasting impact on health outcomes.
Women may gain more than men, and people who feel isolated gain the most. However, the few studies that have been done tend to focus on well-motivated groups, possibly limiting the chance of demonstrating an effect. There is much interest in using these types of community approaches with disadvantaged groups who perhaps have more to gain.
Self-monitoring and self-administered treatment includes things such as encouraging patients to monitor their own blood pressure or administer their own anticoagulation therapy. These can lead to positive results.
Health status can be as good as when these tasks are undertaken by health professionals, and some cost savings may be possible. Given the right tools and support, the evidence shows that people can be empowered to set their own self-management goals and devise appropriate strategies for meeting them. Ironically though, it seems that these initiatives work best when integrated into the health system instead of being separate from it. This means that the role of health professionals in guiding patients through the process is essential. The goal is patient autonomy, but responsibility for achieving this must be shared by patients and health professionals alike.
Patient empowerment techniques help patients take a more active role. These include coaching to increase people’s confidence to take a more proactive role in consultations. They also include cards that prompt them on questions to ask; diaries or topic lists for discussion; and summaries of consultations for later review. Patients’ knowledge and recall are improved; they feel more involved and in control. There is no evidence that this active role prolongs consultations – so it does not increase costs. Evidence about whether it improves physical health is mixed.
Patient decision aids are evidence-based tools to supplement the exchanges between patients and professionals. There are more than 400 available internationally. They use various media (e.g. leaflets, computer programs, audiotapes, compact discs) to help patients review evidence on the effectiveness of different treatments and work out their preferences. Then they can make decisions based on knowledge of the potential benefits and disbenefits of the different options.
Source: World health organization (WHO)