10/12/2013

DISORIENTATION, TECHNICAL LANGUAGE AND POOR HEALTH LITERACY SKILLS ARE MAJOR DIFFICULTIES IN CHRONIC PATIENT SELF-MANAGEMENT

The patient's knowledge on the functions of the National Health System is quite generic, and coordination problems between primary care and specialized care are seen.

Lack of time, technical language and interrupted visits are the main barriers to communication between patients and healthcare providers.

Implementation of health coaching techniques and patient activation by healthcare providers is vital to engage patients in their self-management.

While chronic patients have general knowledge on the functions of the National Health System ―mainly in primary care― they have difficulty understanding the functions of specialized care. Patients find it difficult to orient themselves in healthcare centers, find the different services, identify professionals, and perform diagnostic tests. They complain of receiving bits of information that focus on the next step, which hinders a global view of their healthcare process.

These are the conclusions gathered from the study "An Itinerary of the Chronic Patient", presented today at FAPE headquarters in Madrid and conducted by the Global Institute for Public Health and Health Policies (IGS) of the International University of Catalonia in collaboration with the Spanish Patient Forum, with ESTEVE's sponsorship. The purpose of the study is to know more about the behavior of chronic patients and their healthcare needs.

IGS Director and study publication leader Dr. Albert Jovell, who passed away recently, had stated that "healthcare centers are organized to achieve technical efficiency, but no thought has yet been given to how these centers can be more accessible to and easy to be walked through by patients. Disease-centered care, not patient-centered care, is given."

Provision of information alone has shown to be ineffective in promoting lifestyle changes. Professionals need to implement health coaching techniques and motivate the patient in the self-management of the different phases of his/her disease.

"In this sense, the IGS has developed a number of self-management training programs based on skill acquisition and focused on the needs of chronic patients", says IGS Assistant Director Dr. Mª Dolores Navarro.

Another key message of the study addressed the barriers to communicating with the healthcare provider: lack of time, technical language or interrupted visits, among others, may complicate the relationship and negatively affect treatment follow-up, and self-management. Also, according to the patients who participated in the study, the information they receive is usually too general and lengthy, and is written in a very complex language.

As pointed out by Emilia Arrighi, IGS Research Responsible and Study Coordinator, "this study evidences that elderly people living alone and lacking social support have greater difficulty assimilating self-management behaviors and following therapeutic indications.

The main conclusions of the study emphasize the need to:

· Develop health literacy-centered research projects and screening instruments to identify the profiles of patients with poor health literacy skills.
· Promote the acquisition of skills to improve chronic patient self-management.
· Train healthcare providers in health coaching techniques and patient activation.
· Improve oral and written documentation addressed to the patients by way of education materials focused on their needs, and improve healthcare itineraries.

In order to meet the objectives of this study, qualitative information gathering techniques were used which included semi-structured interviews with experts and discussion groups with chronic patients.

The study presented today is part of a collaboration agreement signed in February this year between ESTEVE, the UIC and the Spanish Patient Forum with the purpose of developing scientific research and training projects to improve chronic patient care ―one of the major challenges currently faced by the health system.

As emphasized by ESTEVE's Institutional Relations Director Eugeni Sedano, "these results are a starting point in the attempt to improve the chronicity care process, establish an integrated framework for action, and encourage action aimed at improving key issues such as patient education or adherence to treatments".

The presentation of the study was held today in Madrid, and the speakers were: Alipio Gutiérrez, President of the National Health Reporter Association (ANIS); Eugeni Sedano, ESTEVE's Institutional Relations Director; Sonia García Sanjosé, Assistant General Manager of Quality and Cohesion of the Ministry of Health, Social Services and Equality; Albert Canals, manager of the International University of Catalonia; Emilia Arrighi, Research Responsible at UIC's Global Institute for Public Health, who presented the study; and Jorge Vázquez, Manager corporations and institutions at ESTEVE, who announced ESTEVE's "ExpertSalud" a new app, free of charge, designed to offer a mobile application likely to help the patient in the management of his/her own health, and particularly indicated in chronic patients who need to improve their adherence to treatment.

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