The Value of Patient Self-Management for Many Chronic Diseases
Posted Apr 18 2011 12:00am
Participatory healthcare is one of the so-called "Four P's" of modern medicine -- the other three are preventive, predictive, and personalized (see: The Future of Healthcare and the Four P's: Preventive, Predictive, Personalized, Participatory ). This approach to healthcare was covered in a recent article that referred to it as self-management of chronic diseases (see: Moving to Self-Management for Arthritis — and Other Chronic Diseases ). The reason that patient participation in chronic diseases is so appealing is that it reduces costs and, more importantly, requires patient buy-in to the process. This inevitably results in more effective care. Here's an excerpt from the article
With obesity, sports injuries and the aging of the baby boomers all driving an increase in osteoarthritis, public health officials are steering patients into self-management programs that use exercise classes, weight management and other lifestyle counseling to reduce pain and disability.... Self-management education has been shown to improve the health of adults with doctor-diagnosed arthritis — the degenerative disease of the joints — by 15% to 30% compared to medication alone. The Centers for Disease Control and Prevention is in 12 states funding programs that include self-management education. In Missouri, for example, CDC funds go to maintain regional arthritis centers; [a spokesperson] says that in the last three years, the program has been serving a younger population and is now targeting more arthritis sufferers at their workplaces. For those adults who can’t find the time to attend classes or workshops offered at the community level, the National Council on Aging is offering an alternative: online courses that use the same principles to encourage patients to manage their condition and strictly follow their regimens, with encouragement from a virtual community. The NCOA licensed a program called Better Choices, Better Health from Stanford University — which developed many of the self-management programs for chronic diseases now being used in the U.S. The online program is for now being offered free in seven states to those with arthritis and other chronic diseases. Jay Greenberg, [from] NCOA, tells the Health Blog that his organization is talking with insurers and employers about making it part of benefit packages to encourage more patients to take control of their symptoms. “We aren’t going to bend the cost curve on chronic diseases unless as a country we put self-management at the center of health care,” says Greenberg.
There's lots of wisdom and relevant information in this article -- you may want to read the whole thing. Here are some of the major ideas that I take away from it:
Many hospitals and physicians will have little interest in patient-participatory, self-management programs. There's not much profit in it at the present time and most physicians are not trained in this approach to healthcare. Luckily, we now learn that the CDC and NCOA are taking the lead in patient self-management initiatives. This is logical given the charters of these organizations.
Workshops on self-management are very important. However and as noted above, these courses are being extended and supplemented by web-based resources. This will allow older patients the opportunity to sample them and also promote educational opportunity for those with limited mobility.
Most importantly, I quote the last sentence in the excerpt for emphasis: We aren’t going to bend the cost curve on chronic diseases unless, as a country, we put self-management at the center of health care. Hopefully, our mainstream health delivery facilities will come to see the wisdom of this idea and participate in these programs at a higher level.
Participatory healthcare is one of the so-called "Four P's" of modern medicine -- the other three are preventive, predictive, and personalized (see: The Future of Healthcare and the Four P's: Preventive, Predictive, Personalized, Participatory ). This approach to healthcare was covered in a recent article that referred to it as self-management of chronic diseases (see: Moving to Self-Management for Arthritis — and Other Chronic Diseases ). The reason that patient participation in chronic diseases is so appealing is that it reduces costs and, more importantly, requires patient buy-in to the process. This inevitably results in more effective care. Here's an excerpt from the article
With obesity, sports injuries and the aging of the baby boomers all driving an increase in osteoarthritis, public health officials are steering patients into self-management programs that use exercise classes, weight management and other lifestyle counseling to reduce pain and disability.... Self-management education has been shown to improve the health of adults with doctor-diagnosed arthritis — the degenerative disease of the joints — by 15% to 30% compared to medication alone. The Centers for Disease Control and Prevention is in 12 states funding programs that include self-management education. In Missouri, for example, CDC funds go to maintain regional arthritis centers; [a spokesperson] says that in the last three years, the program has been serving a younger population and is now targeting more arthritis sufferers at their workplaces. For those adults who can’t find the time to attend classes or workshops offered at the community level, the National Council on Aging is offering an alternative: online courses that use the same principles to encourage patients to manage their condition and strictly follow their regimens, with encouragement from a virtual community. The NCOA licensed a program called Better Choices, Better Health from Stanford University — which developed many of the self-management programs for chronic diseases now being used in the U.S. The online program is for now being offered free in seven states to those with arthritis and other chronic diseases. Jay Greenberg, [from] NCOA, tells the Health Blog that his organization is talking with insurers and employers about making it part of benefit packages to encourage more patients to take control of their symptoms. “We aren’t going to bend the cost curve on chronic diseases unless as a country we put self-management at the center of health care,” says Greenberg.There's lots of wisdom and relevant information in this article -- you may want to read the whole thing. Here are some of the major ideas that I take away from it: