Activating patients to better health
Australians with chronic conditions and complex needs are less activated than their healthier counterparts which may be a contributing factor to their generally worse health outcomes a Consumers Health Forum study has found.
“In October – Health Literacy Month – these findings highlight how frequently people with pressing healthcare needs may be less aware of their condition or able to get the care they need,” the CEO of the Consumers Health Forum, Leanne Wells, said.
The finding comes from a survey, Patient Activation in Australians with Chronic Illness, which canvassed a nationally representative sample of over 1,700 respondents to gauge their level of active engagement in their own health care.
“The aim of this research was to get a clearer understanding of how engaged Australians with two or more chronic conditions are in their own health care. The results can help guide the design and practice of different models of care that move consumers from being passive recipients of care to more active partners.
“One of the barriers to introducing more active care models has been the belief amongst some clinicians and policy makers that consumers are not interested in their own health care and do not want responsibility for self-management or even to be involved in share decision-making.
“This survey dispels that view. It found that about two thirds of respondents with chronic illness had some level of patient activation or self-management in terms of their health care, taking some action or adopting behaviours to support their health.
“The results suggest that chronically ill patients with the highest levels of patient activation have improved health care experiences and outcomes compared to those with the lowest patient activation levels.
“However, that compares with a higher level of patient activation of 85 per cent found in the general population according to another study.
“The study supports CHF’s long held view that more consumer engagement in health care, both at an individual level and in the design and management of health systems would yield significant advances for health care overall,” Ms Wells said.
This data is timely as Australia embarks in the development of 10 Year Primary Health Care and Prevention Plans, announced by Minister Hunt in recent weeks.
Our key recommendation from this research is that both these plans need to include measures to support personalised care and strengthen the capacity of people to manage their own healthcare. Investing in measures to assist general practice teams and patients leverage patient activation to navigate the range of services they need to exercise choice and control in their healthcare as part of a comprehensive national primary health care reform strategy would deliver high value care for those with chronic illnesses.
Measures should include shared decision-making practices, tools, resources and education to support shared-decision making, evidence-based self-management services, workforce development in the form of practice-based health coaches and service coordinators and a social prescribing scheme.
The study also found that mental illness is the most commonly reported chronic condition in Australia, yet only a little more than one third of affected patients see counsellors or psychologists.
Ms Wells said there were many reasons patients with mental illness might not get the counselling and psychological care they needed, including cost, as only a limited number of psychologists’ visits attract the Medicare rebate. Many visits were not bulk billed and there was a case for review of mental health available in the community.
“What is clear is that there needs to be a more active model of engagement for people with mental health issues, particularly those with accompanying physical illnesses where treatment, including medication, becomes more complex and potentially problematic,” Ms Wells said.
The CHF study utilised the Patient Activation Measure (PAM®) tool to determine levels of patient engagement for adults with two or more chronic illnesses in order to inform strategies to support patient self-management.