Creating Empowered Healthcare: Patients, Partners, and Chronic Disease Management
Strategies for Enhancing Patient Accountability in Healthcare, as Exemplified by the Institute of Cardiology
In the modern context, health is about more than just medical treatments and doctor visits. It's about personal choices, self-care, and being accountable for our own wellbeing. This is the philosophy that Raushan Kabikenova, the head of the regional department at the Institute of Cardiology and Internal Medicine, is champions as she spreads the message of patient responsibility and partnership with medical professionals.
She articulates the importance of personal health management bearing quotes from the French writer Jean de La Bruyère, "Health is what people desire most and care for least." This sentiment underlines the foundation of her mission to educate patients, especially those with chronic diseases, to take charge of their health.
Since 2013, the Disease Management Program (DMP) has been a cornerstone of Kazakhstan's healthcare infrastructure. Its objectives include improving the management of chronic diseases, reducing complications, and enhancing overall quality of life. Conditions such as arterial hypertension, chronic heart failure, and type 2 diabetes are among the targeted conditions. In late 2021, chronic obstructive pulmonary disease was also added, given its position as the fourth leading cause of death worldwide.
The heart of the DMP lies in the symbiotic relationship between an informed, proactive patient and a multidisciplinary team at the clinic. This team comprises doctors, nurses, social workers, health promotion specialists, and psychologists who impart essential self-help skills and teach patients how to control factors impacting their health. The ultimate aim is to diminish the incidence of exacerbations, emergency calls, and home visits, while increasing shared responsibility for patients' health.
The Institute of Cardiology and Internal Medicine spearheads this program under the Ministry of Health, ensuring organizational and methodological support, implementation of activities, and monitoring program performance. Their electronic base of indicators helps in overseeing the progress of the PUI (Program for the Integration of Chronic Disease Management) across the nation's regions.
Monitoring reports from September 2020 indicate that nearly 40% of patients afflicted with arterial hypertension, chronic heart failure, and diabetes mellitus participating in the DMP received coverage. The highest participant rates were observed in Atyrau, Karaganda, Turkestan, Pavlodar regions, and Nur-Sultan city.
Positive outcomes have been recorded among patients involved in the management of their chronic conditions. The number of patients elevated to 756,000, accounting for 39.1% of the total registered patients. Stabilization of blood pressure was achieved in 83% of patients with arterial hypertension, and the incidence of new hospitalizations and instances of stroke or myocardial infarction reduced significantly.
Several noteworthy improvements were also observed in healthcare efficiency. The workload and queue in primary care organizations abated, reducing the need for inpatient medical care. Fewer emergency cases were observed among PUI patients, signifying a stronger partnership between the doctor and patient. This partnership fosters discipline, encourages self-care, and instills a sense of responsibility for one's health, leading to improved health outcomes.
Mobile PUI applications have been developed to facilitate real-time remote monitoring of patients with arterial hypertension, chronic heart failure, and diabetes mellitus. Specialist training also plays a critical role in the program's success, with a focus on imparting professional knowledge and skills to multidisciplinary teams across several regions. The DMP is undoubtedly paving the way for better chronic disease management through its community-centric philosophy.
The future of chronic disease management in Kazakhstan looks bright, with a focus on introducing advanced technologies and enhancing preventive measures. By continuing to empower patients and cultivate partnerships with healthcare professionals, the nation stands to achieve even better results in managing and even staggering the progression of these complex, common, and often debilitating conditions.
- Raushan Kabikenova emphasizes the role of personal responsibility in health, citing the French writer Jean de La Bruyère who said, "Health is what people desire most and care for least."
- The Disease Management Program (DMP) in Kazakhstan, launched in 2013, aims to manage chronic diseases such as arterial hypertension, chronic heart failure, type 2 diabetes, and recently added chronic obstructive pulmonary disease.
- The DMP's success lies in the collaboration between informed, proactive patients and a multidisciplinary medical team, including doctors, nurses, social workers, health promotion specialists, and psychologists.
- The Institute of Cardiology and Internal Medicine, a cornerstone of this program under the Ministry of Health, provides organizational and methodological support and monitors the program's progress across regions.
- Positive outcomes have been seen in patients participating in the DMP, with a significant reduction in new hospitalizations and instances of stroke or myocardial infarction for those with arterial hypertension.
- The future of chronic disease management in Kazakhstan looks promising, with focus on adopting advanced technologies, enhancing preventive measures, and further empowering patients while fostering partnerships with healthcare professionals.
