Chest
Volume 130, Issue 1, Supplement, July 2006, Pages 73S-82S
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Decreasing the Global Burden of Asthma
Patient-Focused Care: Using the Right Tools

https://doi.org/10.1378/chest.130.1_suppl.73SGet rights and content

Patient-focused or patient-centered care is not a new concept, but its value has been overlooked in preference to the technology-based, disease-centered model that has prevailed in medicine for the last 50 years. Patient-focused care includes four broad areas of intervention: communication with patients, partnerships, health promotion, and physical care (medications and treatments). We can conceptualize patient-focused care as being the care we would like our loved ones to receive. There is considerable evidence that patients prefer a patient-focused approach. Unfortunately, there are also many studies detailing physicians' disconnection with patients' needs, particularly the need for information, and misunderstandings and assumptions based on poor communication. However, it is possible to develop physicians' skills in patient-focused care and provide physicians with the tools to overcome the barriers to this approach. The patient-focused approach has been shown to improve physicians' performance, patient satisfaction, and health outcomes without requiring additional investment in time or resources. Patient-focused care has also been shown to improve adherence to medication/advice, a well-known problem in asthma. There are also benefits to the physician in terms of improved outcomes for their patients, higher patient retention, and potentially a reduced risk of litigation. Patient-focused care may be a particularly valuable approach for the management of “difficult-to-treat” patients. In summary, the “three Cs” of patient-focused care—communication, continuity of care, and concordance (finding common ground)—are highly relevant to the effective treatment of pulmonary disease and should be a key component of asthma management.

Section snippets

Patient Preferences for a Patient-Focused Approach

Patient-focused care aims to bring more equality into the physician/patient relationship as well as an understanding of the patient, not just their illness. However, models of medical management are generally conceived, tested, and disseminated by medical professionals.1

Do patients want patient-focused care? Little et al4 investigated patients' preferences for a patient-focused approach in the primary care consultation. These investigators4 administered a preconsultation questionnaire to 824

Barriers to Patient-Focused Care

If patient-focused care is preferred by most patients, why is it not universally adopted? In clinical practice, there are significant barriers to patient-focused care that need to be overcome.

Influencing Outcomes With Patient-Focused Care

If patients want patient-focused care, and the barriers to this approach can be overcome, will physicians achieve better results for their patients by adopting this method?

Participant Feedback and Discussion

Among other points, the workshop participants discussed the following:

  • How do we address concerns about adverse events with our patients?

  • Do you counsel patients by agreeing on a plan of action (concordance)?

  • What are the potential barriers to patient-focused care?

Participants highlighted a number of points that they believed formed the basis of patient-focused care (Table 3). Patients are more likely to be motivated to follow treatment advice if they perceive the recommendations to be a

Conclusion

Asthma is a complex disease that in many instances affects patients throughout their lives. The three Cs of patient-focused care—communication, continuity of care, and concordance (finding common ground)—are highly relevant to the effective treatment of pulmonary disease and should be a key component of asthma management.

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    Dr. Irwin has no potential personal or financial conflict of interest to disclose. N.D. Richardson discloses that she was contracted to provide author support on manuscript preparation by BoomCom Communications, Inc., Denver, CO. BoomCom Communications, Inc., was engaged by Altana Pharma, the sponsor of the supplement.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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