For far too long, the approach for management of people living with non-communicable diseases (NCDs) has been based on a curative approach.
This is driven by the idea that health care professionals are the ones who are managing the disease of the patient- giving them the medication required to be able to manage their conditions, while also monitoring disease progression and ensuring that they do not develop complications from their disease.
This has changed somewhat over the past two decades or so, as everyone has come to realise that management of NCDs and their daily conditions requires the person living with the disease to firmly be in the driver’s seat, with everyone else, including health care professionals, overseeing care and playing strong supportive roles.
This is because NCDs are strongly driven by behavioural components; including the need for people living with NCDs to be able to care for themselves in terms of compliance to medication, and reducing their propensity to various risk factors that can play an active part in making their conditions worse.
The issues pertaining to people living with NCDs are tied closely to long-term, sustainable management of their conditions. People living with NCDs need to be better able to take care of the different components of their disease; and run their daily lives while doing this at the same time.
This requires not only them being provided with the medications that require for them to be able to do this, but also the skillsets such as how to monitor and manage their own symptoms. They also require persistent motivational support to be able to be consistent at disease management over a long period of time stretching into years.
In order to ensure that people living with NCDs are empowered to manage their conditions, an active change in terms of how health care systems are managing them need to happen. Health education and mental health behaviour change interventions need to be made part of the formal care processes for people living with NCDs.
And in order to make this happen in a meaningful and effective manner, health care professionals managing people living with NCDs need to be equipped with additional new skillsets.
There are many who will argue that such interventions are already in place in Malaysia. But truth be told, they are actually not. If and when such strategies do exist, they are piecemeal, run in a non-formal manner and rarely embedded into the Standard Operating Procedures (SOPs) pertaining to management of people living with NCDs.
Evidence from the ground proves this. In some places, people living with NCDs are provided with mental health support, while in many places, they are not.
Very little is provided in terms of health education to newly diagnosed or even long-time sufferers of diseases other than a cursory brochure or two, or mere instructions to “Why don’t you Google and find out more about what you can do”. The report can be accessed here.
The reason for this is due to two reasons. The first is the fact that there are never adequate numbers of specific health care professionals such as health care educators and mental health professionals who can support such a transition where such requirements are embedded within formal care processes. This is an existential issue which can only be addressed by a larger transformation of the entire health system.
However, another shortcoming is perhaps more addressable. Current health care professionals caring for people living with NCDs can take a step back and look at the formal care processes being carried out for their patients, and then incorporate small but effective interventions designed to better empower people living with NCDs to be able to manage their conditions.
At the very least, this requires health care professionals to be able to teach patients — and this is a skillset that has not been even considered to be provided to health care professionals working in clinical settings.
Without teaching health care professionals how to teach patients in an effective manner, how can we ever hope that patients will be able to learn enough to do better in caring for themselves?
This article was written by Dr Janice Hew Pei Fang, Mohamad Ishak Ahmad Abir, Thaarenee Wiswannadan, Nariza Alysa Azryn, Dr Jessica Anne Canute, Mahirah Ma’som, Chan Wan Thung, Dr Murallitharan Munisamy, and Dr Saunthari Somasundaram from NCD Malaysia.
NCD Malaysia is the Malaysian chapter of the Global NCD Alliance, comprising 16 organisations that advocate for people living with non-communicable diseases. For further information about NCD Malaysia, please visit the NCD Malaysia Facebook and Instagram pages.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.