Chronic medical diseases such as hypertension, diabetes and heart disease can greatly burden a patient with recurrent need for daily medication adherence and lifestyle changes.
In this global health case report Chima et al. use the Diabetes Distress Scale to pinpoint areas of unease and difficulty in the patient’s view of their diabetes and barriers to medical adherence in order to develop a patient centered coaching. The importance of using a patient centered approach is underlined in the way the healthcare provider will guide the patient through eight sessions of coaching aiming to improve both patient well being and compliance to treatment.
This type of technique can be applied to the entire spectrum of chronic diseases which often burden patients and make them feel helpless with regards to their condition.
When preventative measures, such as this one, bridges therapy with medicine, the potential for a decrease in long term complications can alleviate both disease burden in the patients as well as the financial burden on the healthcare system.
As a physician, we often have too little time allocated to each patient visit, limiting the ability to delve into possible sources of anxiety and aversion to treatment, leading to non compliance. Issues of lifestyle such as exercise and nutrition might be skimmed through but not properly dealt with leaving the patient with little feeling of support in order to treat an all encompassing disease. If we extrapolate this model to heart disease, one can understand the importance of using a scale and coaching in order to emphasize nutritional and lifestyle changes as well as the need for multiple medications. The potential for frustration and feelings of helplessness when faced with a life long need for commitment to self in preventing further manifestations of disease, is large. Furthermore, most patients do not struggle with one but multiple chronic conditions, increasing the likelihood for distress and non adherence.
This case report gives a creative and easy to implement model to guide patient centered coaching to the community and improve medical outcomes.
Chloe Pinto M.D.