Revolutionising non-communicable disease management

Lahja Paulus

Over the past few decades, non-communicable diseases (NCDs), also referred to as chronic conditions, have emerged as a pressing global public health challenge.

According to the World Health Organisation (WHO), NCDs account for a staggering 71% of total global deaths.

NCDs are defined as conditions that are non-transmissible from person to person and require ongoing management over a period of years or decades, with typically slow progression.

Major chronic conditions include cardiovascular disease, cancer, diabetes and chronic respiratory disease.

Alarmingly, sub-Saharan Africa is currently facing a surge in NCDs, owing to an increase in major modifiable risk factors, such as physical inactivity, unhealthy diets, the harmful use of alcohol, and exposure to tobacco smoke.

If the current trend continues, NCDs are projected to be the leading cause of death and disability by 2030, surpassing the burden of communicable diseases globally.

Effectively managing these conditions requires extensive long-term self-management by patients.

As such, it is crucial that patients are involved and actively participate in the management and decision-making related to their conditions.

Most patients battle daily symptoms and medication side effects, and must adhere to medical regimens, special diets and physical exercise plans.

PARADIGM SHIFT

To foster a healthcare system that truly prioritises the individual’s well-being, a paradigm shift is essential – moving away from a disease-centred approach and towards an individual-centric model, known as patient or person-centred care.

This approach focuses on valuing and addressing the preferences, needs, values and goals of each individual.

This implies that healthcare professionals actively engage in a collaborative partnership with patients, acknowledging their autonomy and involving them in the decision-making processes pertaining to their care.

Importantly, person-centred care considers the distinct circumstances and aspirations of each person in need of care.

At the heart of this concept lies the notion of respect.

EMPOWERING PATIENTS

Person-centred care asks healthcare professionals to become active listeners.

It considers the psychological and emotional well-being, social support systems, and lifestyle factors that may impact the individual’s health and ability to effectively manage their condition.

Patients have lived experiences with their conditions, and these first-hand insights best inform interventions to optimise disease control and management, policies and approaches to designing an inclusive health system.

BENEFITS

A growing body of empirical evidence suggests that patient-centred care benefits both patients and healthcare systems.

Person-centred care ensures that patients feel heard, respected and involved in decision-making, leading to high levels of satisfaction with their care.

It empowers patients and enhances their quality of life.

As person-centred care is tailored to patients’ unique needs, there is the enhanced likelihood of achieving positive health outcomes.

Moreover, effective management of NCDs requires proactive and preventative measures along with early detection and intervention.

CHALLENGES

Limited time for healthcare providers to address individual needs and preferences could hinder the effective management of NCDs.

Person-centred care necessitates a greater investment of time in understanding patients’ specific circumstances and involving them in decision-making.

Re-evaluation of scheduling and workload practices, along with the adoption of innovative tools, is necessary to overcome this obstacle.

Additionally, hierarchical structures and power dynamics within healthcare systems could impede the shift towards person-centred care for NCDs.

Healthcare professionals must receive training and education in empathy, active listening and shared decision-making to effectively manage NCDs in a person-centred manner.

Resistance to change could pose another hurdle.

Overcoming this would require strong leadership and organisational support, incentives and ongoing training.

Prioritising resource allocation, including time, staff and finances is of the essence for effective NCD management.

The current healthcare management of chronic conditions is unsustainable and does not effectively meet the needs of individuals.

– Lahja Paulus is a registered nurse and midwife, a global health specialist, and is currently working as a senior clinical research nurse for the Manchester University NHS Foundation Trust.

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