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WASHINGTON, D.C. (May 14, 2012) — There is growing evidence that patients who take an active role in their own care are more likely to adhere to treatment plans and tend to have better outcomes and be more satisfied with their care. However, for the most part, medical care today is focused on medical procedures and office-based visits, which often do not adequately support ongoing disease management for heart disease and other chronic conditions. The American College of Cardiology (ACC) today released a policy paper outlining key recommendations to help advance the field’s progression toward a patient-centered approach to cardiovascular care.
The report is an outgrowth of ACC’s ongoing efforts in this area and was developed by a committee representing cardiology, general medicine, pharmacology and nursing, as well as patients themselves. It provides clinicians and patients with strategies to help individual patients gain the requisite know-how, tools and confidence to help manage their disease as an integral part of heart care teams.
“Patient-centered care is crucial to heart disease management and, as cardiovascular specialists, we strongly believe this is the type of care we should be providing,” said Mary Norine Walsh, M.D., FACC, medical director of the Heart Failure and Cardiac Transplantation Programs at St. Vincent Hospital and chair of ACC’s Patient Centered Care Committee. “Beyond knowing the technical aspects of the disease, we need to do a better job of understanding patients’ perception of their disease, their goals and life experience so we can together chart a course for how we are going to manage the disease.”
Such thinking represents a fundamental shift away from the traditional disease-centered model of care to one that considers the whole patient.
“As clinicians, we have been taught for many years to give patients orders and expect things to happen,” said Alfred A. Bove, M.D., Ph.D., professor emeritus, Temple University School of Medicine and vice chair of ACC’s Patient Centered Care Committee. “But when it comes to the day-to-day management of chronic conditions like heart disease, we have to empower patients to be actively involved in their own care. We won’t be effective unless we move toward a patient-centered approach. This initiative is intended to help us get there.”
Among other things, the report calls on cardiology practices and medical centers to educate patients about their heart condition, treatment options and goals. In doing so, authors say clinicians need to have a variety of educational materials available that are easy-to-understand and suit different learning styles.
“We can’t assume that even an educated person has adequate understanding of their own medical condition,” said Dr. Bove. “A well-trained lawyer or engineer may be very good at their own trade, but they may not have the knowledge base we’d like them to have for long-term care. We have to provide health information and tools that can be easily understood and do a better job of making sure patients have not only heard, but understand and can act on the information we provide.”
Of course, providing this type of care within the typical 15-minute office visit is challenging, if not impossible, adds Dr. Walsh. Education and self-management tools, including tools to manage and monitor blood pressure, weight and fluid intake, can allow clinicians to extend their support beyond the healthcare setting. And because people with heart disease make choices every day that can affect their heart health, tools for managing diet, exercise and medication compliance can help patients take greater responsibility for managing their condition.
For example, as Dr. Bove explains, patients who are encouraged to monitor and regularly report their blood pressure readings to their health care team are constantly aware of their condition and have an incentive to take their medications – mainly because they have become part of the care process.
In addition to encouraging that patients become involved in collaborative care planning and goal setting, the report also advocates for routine assessment of patient-centered outcomes such as symptoms, function and quality of life.
All of the recommendations are designed to provide specific approaches and tools to that will be required to facilitate and uphold key aspects of patient-centered care, including:
• Enhanced clinician–patient communication
• Greater attention to patients’ health literacy
• Clinician-directed patient education
• Assessment of patient-centered outcomes
• Shared decision-making
• Collaborative care planning and goal setting
• Patient empowerment and self-management
Drs. Walsh and Bove are the chair and vice chair, respectively, of the policy statement. The full report will be published in the June 5, 2012, issue of the Journal of the American College of Cardiology and will be accessible on the ACC web site (www.cardiosource.org).
About the American College of Cardiology
The American College of Cardiology is transforming cardiovascular care and improving heart health through continuous quality improvement, patient-centered care, payment innovation and professionalism. The College is a 40,000-member nonprofit medical society comprised of physicians, surgeons, nurses, physician assistants, pharmacists and practice managers, and bestows credentials upon cardiovascular specialists who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at www.cardiosource.org/ACC.