According to a new American Heart Association Scientific Statement published today in Circulation, adult cardiovascular care focusing on the patient can enhance individual experiences and medical outcomes.
Patient-centred care revolves around recognizing the patient as an individual and respecting their beliefs, preferences, and values. It merges the healthcare professional’s expertise with the patient’s health priorities, empowering patients through informed decision-making by providing clear information and fostering an active partnership among the patient, their family, and the healthcare team. Michael J. Goldfarb, M.D., M.Sc., chair of the scientific statement writing committee and associate professor of cardiology at the Jewish General Hospital and McGill University in Montreal, Quebec, emphasized that patient-centred care involves informed choices rather than allowing patients unrestricted freedom in their healthcare decisions.
Dr Goldfarb also highlighted the necessity for healthcare professionals managing adults with heart disease to acquire guidance and practical tools for integrating a person-centred approach into regular clinical practice. The statement outlines several critical components of patient-centred care, including shared decision-making, medication management, and focusing on patient-oriented outcomes.
Shared decision-making is characterized by a collaborative relationship based on trust, mutual respect, and open communication between patients, families, and healthcare professionals. Health professionals must accommodate their patients’ health literacy levels and provide transparent, straightforward information about risks, current health conditions, and the potential outcomes of different screening and treatment options, encouraging patients to engage in discussions about their health.
Although the effectiveness of medications in preventing and treating heart disease is well-documented, adherence issues are significant, with many patients not consistently taking their medications as prescribed. This can be due to various factors, including the complexity of medication regimes and the cost of drugs. Engaging patients in discussions about their medication can help improve adherence, reduce costs, and minimize side effects, possibly through the use of combination pills or substituting expensive medications with cheaper but equally effective alternatives.
The statement further stresses the importance of incorporating the patient’s physical, emotional, and social well-being assessments into managing their heart disease. This holistic view allows healthcare professionals to understand better the patient’s condition and the effects of treatments, recognizing changes that might not be apparent through standard medical examinations alone.
Dr. Goldfarb also pointed out that care outcomes significant to health professionals and health systems might only sometimes align with what is important to patients. For instance, while the length of hospital stay is a standard metric for care quality, patients might prioritize their overall quality of life and functional ability post-treatment more highly.
The statement also addresses the need to overcome barriers to implementing patient-centred care, particularly for populations burdened disproportionately by cardiovascular disease. This includes deploying culturally and linguistically appropriate services and considering social determinants of health such as economic stability and access to quality healthcare. Special attention is given to different demographics, such as older adults, women, individuals with behavioural and mental health issues, adults with congenital heart disease, and those with physical disabilities, emphasizing tailored approaches that consider their unique health needs and circumstances.
Moreover, the statement acknowledges the obstacles to patient-centred care stemming from patient, clinician, and health system-related factors. These include patients’ distrust or limited access to healthcare, clinicians’ time constraints and documentation demands, and health systems that may need more resources for team-based care.
In conclusion, while there are challenges to genuinely patient-centred care, the statement underscores that it is achievable and already practised to some extent. As highlighted by Dr Goldfarb, the ongoing development and incorporation of patient-centred outcome measures are vital for optimizing care for patients, their families, and caregivers.
More information: Michael J. Goldfarb et al, Patient-Centered Adult Cardiovascular Care: A Scientific Statement From the American Heart Association, Circulation. DOI: 10.1161/CIR.0000000000001233
Journal information: Circulation Provided by American Heart Association
