Hurley Health Services - Patient Self-Management
What does it mean?
Patients battling chronic diseases such as Asthma, Diabetes, Hypertension, Congestive Heart Failure (CHF), Coronary Artery Disease (CAD) and Chronic Obstructive Pulmonary Disease (COPD) have complex and often overlapping medical needs that our health system has struggled to meet.
Primary Care Physicians (PCPs) have been asking patients to follow “doctor’s orders” for years. Clinicians are trained to diagnose, instruct, and take charge of the treatment process. But evidence increasingly shows that patients with chronic disease do best when they themselves take a leading role, making informed decisions about health goals and pursuing them confidently, with caregivers as partners, offering support, education and practical help in overcoming barriers.
The evidence is growing that self-management interventions, such as self-monitoring and decision making, compliance with medications and treatments lead not only to improvements in health outcomes and health status, but also to increased patient satisfaction and reductions in hospital and emergency room costs. Physicians and patients are working together in the patient self-management process enabling the patients with chronic conditions to stay healthier, avoid hospitalizations, and remain engaged in their family lives, work and communities.
Around 90 percent of the care a person needs to manage a chronic disease must come directly from the patient. Self-management has been a basic belief of chronic disease management for a long time. However, often the patient’s attitude towards self-management has been to go to the doctor for medication or a quick treatment. This approach is no longer viable because it provides only satisfactory responses to short-term problems and stretches medical professional resources thin. Add to this the basic fact that 75% of all adults over 65 have a chronic illness – half of this group has multiple illnesses– and it is easy to see how medical provider’s resources are struggling to provide cost-effective, quality care to their chronic disease patients. The end result is that self-management has to mean more than the patient following doctor’s orders. Self-management in today’s world needs to promote a more active role for the patients in their own healthcare solutions.
What does this mean, though? It means acknowledging that the patient should play a lead role in managing their care. This does not mean that the patient should go it alone, but a collaborative approach needs to be employed where medical professionals and patients work together to define problems, set goals and create action/treatment plans.
Another difficulty in providing effective management of chronic disease is that often patients go several months between medical appointments. More frequent visits are simply too costly for patients and too time consuming for care givers. This is especially true in cases where appointments often include no actual medical treatment, but are used to exchange information between patient and medical professional. This strongly suggests that an effective self-management strategy must improve communication between medical visits.
Several different strategies have been looked at over the years to improve self-management, and according to the National Health Institute one thing is clear – any program adopted should be readily applicable to more than one condition. This is because multiple strategies make it difficult for the whole health care team to be on the same page. There are also six core strategies that should be included in any effective self-management routine:
- Patient self-education about their condition
- Routine monitoring and management of symptoms
- Patient/Professional partnership in deciding when medical help is needed
- Communication between patient and professional via means other than just face-to-face
- Developing and maintaining appropriate exercise and nutritional programs
- Finding ways to do the above with minimal impact on the patient’s life
If you should have any questions pertaining to Patient Self-Management, please call your Primary Care Physician to discuss your illness and treatment options as well as how you can help in improving your health. |
