Many of the methods in use today for measuring health behaviour change lead to confusing, sometimes contradictory outcomes. There is an ongoing search to find the value in medicine and healthcare, particularly value offered to the patient.
Few in the medical community would argue against the need to improve patient adherence to medications or prescribed courses of action designed to alter behaviour. If a patient won’t do as the doctor orders, or won’t take their medicine properly, how are they supposed to get better?
The ‘problem’ with patients is they’re people, and many people are naturally resistive to change. We’ve all had experiences where we’ve doubted our ability to live up to the expectations of experts, or occasions when we felt overwhelmed and unable to accomplish all that was asked of us.
Therefore, there’s such a strong emphasis in medicine today on creating patient-centred programmes. By putting the patient at the heart of their own treatment, especially when it comes to persuading them to adopt sometimes challenging interventions, it is hoped they’ll take more responsibility as individuals and move towards greater self-management.
The patient/physician disconnect
The real meaning of ‘patient-centred’ often gets lost in the drive to create new programmes and health interventions. Many surveys have revealed the difference between what’s important to patients and what’s important to doctors. Even dissimilar patients can have differing ideas about what’s important, so being patient-centred for healthcare professionals is far from a straight line between A and B.
The value outcome of medicines is still largely measured against healthcare systems or general societal outcomes. To be truly patient-centred, programmes need to rather focus on value to the individual, and find a way of measuring health behaviour change at an individual level.
Focusing on outcomes
Evidence-based guidelines are often followed when seeking to provide quality care. The guidelines are, however, measured more on the process followed than the actual outcome to the patient. This can put the patient at odds with the evidence-based approach, since if a programme is proven to work with the population in general, why won’t it work with everyone?
Another way of measuring health behaviour change is to adopt a ‘goals’ oriented perspective within a programme that considers the patient’s point of view. Instead of measuring clinical outcomes alone, also measuring quality of life can result in significant improvements in patient outcomes.
Adopting a ‘goal-focused’ outcome, with the goal being informed by the patient’s point of view, allows for some flexibility and a more intuitive way of measuring health behaviour change, since the change needed is defined by the individual patient.
Having identified the required behaviour change, barriers can then be explored and exposed, and a highly-targeted intervention designed with the final goal in mind.
Such interventions offer immediate value and benefits to the patient. And because they’re so highly targeted, with clearly defined goals, measuring health behaviour change is simpler and likely to yield a more positive outcome - for healthcare professionals and for patients.
Patient-centricity is a trend set to continue for the long-term, and there is no shortage of innovation or enthusiasm in the medical community for designing new programmes. But the ways in which we measure patient benefits and value needs to be equally creative.