Patient-centric harm reduction healthcare approach is the need of the hour to improve health outcomes

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Healthcare practitioners should consider variability in every individual to tailor treatment plans accordingly

New Delhi, 7 December 2018: Research indicates that in India, out-of-pocket expenses make up for most of the health financing mix, in turn driving catastrophic expenditure for individuals. This results in a significant economic burden on marginal sections of the population further creating barriers to appropriate health seeking behavior. Harm reduction is gaining popularity as a public health strategy to reduce the potential risks associated with health behaviors.

The need of the hour is to adopt a patient-centered and harm reduction approach to treatment in India. The concept of “Individualization” — inherent in the science of homeopathy — recognizes every patient to be different from the other, even if they have the same disease and individualizes treatment for every person.

Speaking about this at the 4th Edition of The Healthcare Summit organized by Mail Today at The Lalit, New Delhi, Padma Shri Awardee, Dr KK Aggarwal, President, Heart Care Foundation of Infdia said, “The modern system of medicine is also now shifting towards person-centric medicine. Every patient must be managed differently for the best possible outcome. What is acceptable to one patient, may not be acceptable to the other. Treatment must be tailored to each individual patient taking into consideration their individual characteristics, culture, personal preferences, expectations etc. The social determinants of health including the patient’s social situation, environmental factors that influence the health of a person, etc. are also different. Their personal and family history including medical history are different. Individual response to drugs may vary, the side effects may vary. Patients not willing for quiting high risk behaviors may like to shift to less harmful ones. All these variables need to be taken into account when formulating a treatment plan.”

The Institute of Medicine (IOM) has defined patient-centered care as: “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.” Other eminent specialists including Dr Mahesh Verma, Dr Nand Kumar,; Dr V C Khilnani, and Dr Deepali Bhardwaj also presented their views at the summit.

Adding further, Dr Aggarwal, said, “Given the heterogeneity of individuals, the standard treatment guidelines also need to be challenged. Guidelines are evidence-based recommendations for groups of patients, but not the individual patient. While they give a direction, they cannot be applied to all patients alike. Doctors must exercise clinical judgement in selecting the best treatment option for a particular patient. Individualized treatment plans are based on the unique demands of a patient and address his/her needs. They also involve the patient and encourage shared decision making with the patient and the family.”

The core principles of Universal Health Coverage.

• Accessibility: All patients have the right to access the healthcare they need and when they need it.

• Patient-centeredness and equity: All people, regardless of disease or condition; age, gender, race or ethnic background; sexual orientation; geographic location; socio-cultural background, economic or legal status, must have fair and impartial access to quality healthcare.

• Choice and empowerment: All patients have the right to know about the healthcare services that are available. Patients must be able to be meaningfully involved in healthcare decision-making in a variety of ways at the local, national, regional and global level.

• Quality: It is not enough for all patients to have access to healthcare. Provision needs to be safe, of the highest attainable standard and include a commitment to learning and improvement. Patients need to define what constitutes quality in healthcare.

• Partnership and collaboration: Patients have a moral and ethical right to play a meaningful role at all levels; in health and in other areas that can have an impact on health and wellbeing.

• Sustainability and the value of healthcare: All stakeholders need to recognize the value of healthcare when considering investing in universal health coverage.

• Accountability and transparency: Accountability and transparency are vital to delivering safe, effective and affordable healthcare. All stakeholders need to be held accountable on commitments they have made to implement universal health coverage and be accountable to the patients that they serve.