Patient-centered adult cardiovascular care can improve individual experiences and health care outcomes, according to a new scientific statement from the American Heart Association released today. Circulation.

Patient-centered care means seeing patients as individuals and respecting their beliefs, preferences, and values. Patient-centered care combines the expertise of medical professionals with consideration of a patient’s health priorities. This includes empowering patients to make informed decisions by providing information and building active partnerships between patients, families, and health care teams. Patient-centered care does not mean that patients can choose what they want, when they want it. ”

Michael J. Goldfarb, MD, MSc, Scientific Statement Writing Committee Chair and Associate Professor of Cardiology, Jewish General Hospital and McGill University, Montreal, Quebec, Canada

“Health care professionals who manage heart disease in adults need to receive guidance and practical tools on how to incorporate person-centered care approaches into their daily clinical practice,” said Goldfarb.

The new scientific statement describes several essential elements of patient-centered care, including shared decision-making, medication management, and patient-centered outcomes.

Shared decision making is a collaborative partnership between patients, families, and health care professionals based on trust, mutual respect, and open and honest communication. Healthcare professionals should consider patients’ level of health literacy and provide clear, appropriate, jargon-free information about risk factors, current health status, reality, and the risks and benefits of possible testing and treatment options. must be provided. Patients need the opportunity to ask questions, express their values, preferences, and goals, and work with their health care team to agree on a heart disease management plan.

The benefits of using medications to prevent and treat heart disease are well known, but for a variety of reasons, more than half of patients with cardiovascular disease do not always take their medications as prescribed. Conditions such as high blood pressure and high cholesterol increase the risk of heart attack and stroke, but these non-symptomatic conditions are often undertreated.

Patient-centered discussions about current and proposed medications can also help improve adherence to needed medications and minimize drug costs and side effects. In some cases, using combination pills may reduce the number of pills you need to take each day, or a less expensive, equally effective drug may be used instead of a more expensive option. Having an open and honest conversation about medications can also lead to the decision to eliminate long-standing medications that may no longer be needed.

“Patient preferences and goals must be established and considered before initiating, adjusting, or discontinuing cardiovascular medications,” Goldfarb said.

Physical exams and laboratory tests provide important data about a heart patient’s condition, but patient-centered care requires people’s own understanding of physical function, symptom burden, mental health, social functioning, and quality of life. Reports are included. Gathering this information allows health care professionals to have a more complete picture of a patient’s condition, detect subtle changes in the progression of heart disease, and detect the impact (negative or negative) of current or proposed treatments. Plus) will be able to be evaluated.

“While some care outcomes are important to health professionals and health systems, they do not always reflect what is important to patients. For example, length of stay is an important indicator of quality of care. Although often recorded as indicators, patients should prioritize physical function and quality of life after a heart attack,” Goldfarb said.

Ensuring patient-centered care for everyone

This statement gives special attention to overcoming barriers to patient-centered care and extending it to populations bearing the high burden of cardiovascular disease. for example:

• People of underrepresented and historically underserved races and ethnicities have the highest rates of cardiovascular disease and mortality and are influenced by adverse social determinants of health (including measures such as SDOH, economic stability, education, neighborhood safety, and access to quality health care) There are many. Effective patient-centered care may include the use of tools to assess SDOH, followed by care by a culturally and linguistically competent multidisciplinary team including social workers, interpreters, and patient navigators. is provided.
• senior citizen In addition to heart disease, they often face other complex health issues related to aging. Patient-centered care requires consideration of age-related risks (e.g., multiple medications, frailty, dementia, falls, social isolation) when evaluating the pros and cons of different medications and interventions.
• woman You can benefit from patient-centered cardiovascular care throughout adulthood, including the prevention and treatment of pregnancy-related heart disease and menopausal care.
• People with behavioral and mental disorders You may face psychological challenges that often affect your heart health. Patient-centered care for these populations should include behavioral health services in addition to specialized cardiovascular care.
• Adults with congenital heart disease A growing group of patients benefit from a patient-centered approach throughout their lifespan as they transition from pediatric to adult care and face decisions regarding advanced medical and surgical treatments.
• people with physical disabilities They often have limited access to health care services and report worse overall health than adults without disabilities. The statement said health systems should address inadequate access to preventive care and treatment for heart disease and other chronic conditions for individuals with disabilities.

Barriers to patient-centered care

There are many barriers to incorporating patient-centered care, including barriers from patients, clinicians, and the health care system.

• Patients may mistrust or lack access to the health care system, have limited health literacy or English proficiency, or have cultural barriers to communicating with health care professionals. They may be more concerned about their caregivers or family members than themselves, or they may have conflicting medical beliefs or preferences. Along with the best health habits.
• Clinicians, who operate under time pressure and increased demands for documentation, may have different incentives than patients, and employees may lack diversity in the patients they serve. You may also work in an environment.
• Health systems can be fragmented, with limited access to specialty care, limited space, inadequate systems for sharing information, and/or team-based care may be missing.

“Patient-centered care is possible and is already being achieved to some extent in today’s health care delivery systems.Further development and incorporation of patient-centered outcome measures will optimize care for patients, their families, and caregivers. “It is important to make this happen,” he said. Goldfarb.

This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association’s Council on Clinical Cardiology. Council on Cardiovascular and Stroke Nursing. Hypertension Council; Council on Lifestyle and Cardiometabolic Health. Council on Peripheral Vascular Disease. Care Quality and Outcomes Research Council. American Heart Association scientific statements help raise awareness about cardiovascular disease and stroke issues and promote informed medical decisions. A scientific statement outlines what is currently known about a topic and areas where additional research is needed. Scientific statements serve to create guidelines, but do not recommend treatments. American Heart Association guidelines provide the association’s official clinical practice recommendations.