Have you struggled to help your patients become partners in their care? These tools and practical tips from patients may help.
In previous issues of Rheumatology Republic, we’ve talked about areas where we believe patient-doctor communication strategies can be improved.
In Talking about sex with your arthritis patients we suggested ways you can sensitively allow patients to bring up concerns about their sexual function and the impact that has on their life.
In How patients want their healthcare team to communicate, we implored you to be extra vigilant about the quality of communication with our other healthcare providers.
Now, we bring you ways you can help empower your patients to get more involved in their care.
Patients with chronic conditions are often shared decision-makers when it comes to our health – however, it’s easy to be complacent. We’re guilty of not following treatment plans or engaging in activities in our community that would benefit our overall wellbeing at times as well. (The CreakyJoints Australia team are no exception.)
Here are three tools and strategies that can help you empower your patients today.
Health tracking tools
Hearing how your patients are faring in between appointments is an essential part of your work but we don’t always make that easy. We can be vague about when symptoms started, when we stopped taking our meds or other lifestyle factors that might be impacting our health.
No doubt, you’ve suggested that your patients start a diary to track their symptoms, medications and other indicators of health, but how often do you give them the tools to do that?
Digital health technologies, such as online patient education tools, are plenty but it can be difficult for patients to know which ones to use and how to use them. One thing you can do is give your patients a list of health tracking apps you recommend, such as the NPS MedicineWise app or FitBit. Some apps might focus on specific things like sleep quality, mental health or nutrition.
Rather than simply telling them about the apps, open them and show your patients what the apps can do. Give patients a copy of your list with relevant website links and (where possible) tips on how to use the apps.
For those who aren’t computer literate or prefer hard copies, you can give them printouts of relevant tracking diaries from sites like Free Printable Medical Forms. Show them how to use the forms and ask them to bring the completed forms with them to their next appointment.
Optional update questionnaires
Pre-appointment questionnaires are commonly used for new patients but consider offering update questionnaires to all patients as conversation starters.
Samples of questions could be:
- Have you noticed any patterns that concern you in your health tracking results?
- Were there any barriers/enablers that influenced your health tracking results?
- Have you experienced any issues accessing the health and support services you need?
- Is there anything about your physical, mental or emotional health that is causing you concern?
An update questionnaire won’t be relevant for all patients or all appointments. However, providing them as an option would allow your patients to bring up subjects that might otherwise be missed.
Social prescribing
As healthcare systems move towards patient-centred models, there is growing evidence that social prescribing is an effective tool in this area. It recognises that social, economic and environmental factors play a significant role in people’s health and wellbeing.
This model is discussed in depth in the RACGP and Consumers Health Forum of Australia report Social Prescribing Roundtable – November 2019. The report states social prescribing supports a shift in the focus from illness to wellness and increased consumer enablement and self-management.
The idea is that health professionals include referrals to a range of local, non-clinical programs or services or as part of a holistic treatment plan for their patients. Referrals can be arranged for participation in activities such as community sports, craft groups, volunteering and more. They can also be for practical support like financial counselling or community housing services.
The report notes people with chronic physical health conditions and multimorbidity are amongst those who can benefit from this model as they are more likely to be socially isolated, have financial constraints or have difficulty navigating the health system. Social prescribing could help them broaden their sense of identity beyond their illness or condition and increase their self-care through engagement with peers and community activities.
We understand that you are already time-poor and implementing a social prescribing model into your practice would involve significant reform. Therefore, we suggest you pull ideas from the model that you can do now.
For example, you could “prescribe” an action plan of activities for your patients to do between appointments. This could include encouraging them to join a book club or peer support group to help them with their mental health and social engagement or writing a list of physical exercises for them to do.
We know many of you already refer patients to allied health practitioners and may suggest other community organisations for them to contact. You, your practice nurse or reception staff could take this a step further and provide patients with a list of local community organisations patients could connect with.
We know some people still won’t do what you suggest but putting the tools in their hands is a great start.
CreakyJoints Australia resources
Health and community services for people with chronic health issues: creakyjoints.org.au/health-community-services-people-chronic-health-issues/
Government support for people with chronic illness: creakyjoints.org.au/government-pensions-benefits-services-people-chronic-health-issues/
Other resources
Free printable medical forms: freeprintablemedicalforms.com/
NPS MedicineWise, MedicineWise app: nps.org.au/medicinewiseapp
Royal Australian College of General Practitioners and Consumers Health Forum of Australia, Social Prescribing Roundtable November 2019: chf.org.au/sites/default/files/social_prescribing_roundable_report_chf_racgp_v11.pdf
Australian Disease Management Association social prescribing initiatives: adma.org.au/social-prescribing-initiatives/
Rosemary Ainley wrote this article on behalf of the CreakyJoints Australia team.
CreakyJoints Australia would like to thank Rheumatology Republic for this opportunity to share the patient voice within the Australian rheumatology community.
