Category Archives: Healthcare Solutions

Lifestyle Interventions in the Midst of Three Health Crises

By Hui Xie-Zukauskas Healthy Lifestyle in Right direction_CPD-Clipart combo

As a nation, we are facing three health crises: (1) Chronic diseases, (2) Obesity, and (3) Opioid epidemic.

The facts and figures below tell a sad story.

Impact of three health crises in the U.S. (estimated in 2016)

 

 

Morbidity

 

Mortality

% of All Death

Chronic diseases 25% of adults had two/more chronic health conditions. 595,690 deaths (cancer);  610,000~ deaths (heart disease) 48%
Obesity epidemic 36.5% of adults were obese; 35.6%, overweight. 300,000+ deaths (obesity attributable) 18%
Opioid overdose   59,000 – 60,000 deaths  

*Data compiled from CDC, NIH and other health institutes.

Chronic diseases not only affect health and quality of life, they also add economical and social burdens. Specifically, about 86 percent of all health care spending goes towards treating individuals with one or more chronic conditions.

On the bright side, just eliminating three risk factors – poor diet, inactivity, and smoking – would prevent: 80% of heart disease and stroke, 80% of type 2 diabetes, and 40% of cancer, according to the Centers for Disease Control and Prevention (CDC).

It’s clear that poor lifestyle choices are key contributors in developing preventable chronic diseases such as cardiovascular disease, hypertension, diabetes, several types of cancer, and obesity. Lifestyle modification or intervention is not something new. However, it’s quite challenging to achieve and sustain success. So, here I will emphasize some key strategies and points you can use to fight these health crises personally.  

1. Keep a healthy diet. Intake a diet rich in vegetables, fruits, fish, beans, whole grains, nuts and other nutrients.

-          Reduce fats, sugar and salt in your diet, which may be packed as hidden ingredients in processed foods.

-          Reduce red meat, animal meats consumption too.

2. Participate in physical activity. Aim for a minimum of 150 minute exercise each week.

A combination of diet and exercise is effective in maintaining healthy weight. Take advantage of summer outdoor activities (e.g. swimming, walking, or playing at beach).

3. Quit or avoid addictive behavior such as tobacco, alcohol and illicit drug use.

-          Tobacco smoking takes more than 480,000 lives each year.

-          Rather than seeking substances as a mean for momentary pleasure, living a healthy lifestyle is an excellent regimen for meeting one’s physical, emotional, and social needs.

4. Maintain healthy weight. Weight control is about energy balance, i.e. Energy In = Energy Out. When energy intake exceeds energy expenditure, weight gain occurs.

-          Do eat good breakfast, and consume enough fibers and proteins.

-          Avoid emotional eating.

-          Yes, it’s not easy to make a big change. One step at a time. Don’t go it alone, lock arms for support and motivation.

5. Manage stress. There are many techniques to relieve stress, but the best ones are enjoyable, self-help ways that work for you.

-          Importantly, keep counting your blessings, because gratitude is a secret to happiness.

6. Get a good night’s sleep. Many people overlook this issue.

-          Lack of sleep for a long time may increase your risk of obesity, diabetes, and cardiovascular disease.

-          Sleep hygiene is essential to getting sound sleep (see previous article)

All of above healthy habits will effectively reduce triglyceride levels, cut blood sugar levels, minimize waist circumference, and lower blood pressure. As a result, most chronic conditions and obesity are preventable, and some can even be reversed.

So, go for a healthy, vibrant lifestyle!

 

Image credits: https://openclipart.org/; CPD

Medication Adherence Is No Trivial Matter

By Hui Xie-Zukauskas

Med.Adherence n ProvidersPayers_CPDn2otherImagine you want that magic pill to lose weight or you just got the right drugs to effectively cure your illness, but in either case, you let the pills sit somewhere around your house… How would it help you?

Sadly, failure to take prescribed medications causes about 125,000 deaths annually, according to the CDC.

That’s why I talk about medication adherence and the consequences of non-adherence. Medication adherence implies that a patient takes the medication(s) prescribed by his/her doctor, following the dosage, time or frequency, duration and direction.

Issues on taking medications have been an age-old yet multifaceted challenge, which has some across-the-board consequences. Adherence is especially low among patients with chronic illnesses. And it often happens among elderly people too.

It may surprise you how significant this matter is. Let’s start with reasons for adherence.

Why should a patient take medications faithfully and rigorously?

Medication adherence and therapeutic satisfaction are profoundly tied together.

  1. Your adherence to correctly prescribed medication is essential to clinical-efficiency, cost-effectiveness and positive outcomes.
  2. Adherence to the right regime or course of therapy prevents the development of adverse drug events (ADEs) or adverse drug reactions (ADRs) in many ways.
  3. In the sphere of “cost”, if you try to reduce medication cost by taking it irregularly or delaying the refills, the full therapeutic pay off will not be achieved, and worst, a risk of declining health and increasing cost will transpire.
  4. Non-adherence can lead to hospital readmission, esp. in cases of critical health problems, and potentially affecting clinical quality improvement.
  5. Non-adherence is a $ Multi-Billion problem. “Between $100 and $300 billion of avoidable health care costs have been attributed to nonadherence in the US annually.” (Iuga & McGuire. Risk Manag Healthc Policy. 2014; 7:35-44)

It’s worthy to emphasize that many biological events in the body take place between drug dose and its response, including the release of the drug, absorption, distribution, metabolism, secretion and clearance. Plus, drug interactions with coexisting substances or factors could be severe or subtle. So, non-adherence to medication could result in some unanticipated incidents.

So, what are likely roots of non-adherence?

They can be divided into TWO categories: System (external) and Patients (internal)

Systems / External to Patients – just name a few

  • Discontinuity of care – esp. from hospitalization to subsequent discharge home when lacking a proper direction
  • Multiple changes in medication regimens
  • Inadequate education or instruction of drug use to patients
  • Lack of information on side effects of drugs and preventative measures
  • Drug design itself: e.g. formulation, packaging, inconvenience or high cost, etc.

Patients / Internal Causes

  • Failure to fill the prescription at the start
  • Failure to refill the medications consistently
  • Forgetfulness – esp. in older people
  • Exhaustion of multiple medications
  • Discontinuity due to a side effect, fear of side effects, finance or misled information
  • Inappropriate use of medication
  • Intentional decision to not take the medication
  • Lack of understanding diseases or poor health literacy
  • Physical difficulties, esp. with swallowing big tablets or capsules, opening bottles or containers, or obtaining prescriptions.

Understandably, non-adherence may occur above all when a patient’s expectation for therapeutic benefits goes beyond the actual benefits, or when medication cost is greater than a patient anticipated.

If non-adherence is an issue for you, it’s time to reflect and deal with the root problem following the explorative list above. Surely it could be something outside it.

Finally – How can you stick to your medications?

Medical adherence is one of keys to better health care. Interventions to reinforce adherence from clinicians and allied health professionals need to be improved. On the other hand, I’d like to highlight what you can do to stay on your medication regimen and optimize your health.

10 Strategies & Tips for Medication Adherence

  1. Take a driver’s seat for your care. Before a drug prescription, talk with your physician to understand why the medication is needed and what benefits it produces. By making a mutual agreement or decision, it will enhance your adherence in the beginning.
  2. Counsel with a pharmacist at your local pharmacy if you have any concern or trouble with your drugs, and they are happy to help with adequate knowledge and advice. Bonus – it’s free of charge.
  3. Comply with the instruction. This is very important as mentioned earlier that drug dosing can impact your body in various ways. For example, some drugs need to be taken in the morning and others in the evening; some once a day, others four times a day; some with a full stomach, others with an empty one…
  4. Have a self-management system – i.e. use a pillbox, take the medication at the same time each day and ideally couple it with a specific daily task or routine, color-code different time points, refill the medications at the same time each week, and order your medications 7-10 days ahead… you got the idea. It’s practical and effective, esp. for older people who use multiple drugs or drugs that must be taken several times a day.
  5. Find a creative way to remind yourself. It could be a sign, a framed memo or a decorated item/box, or an alarm. And make sure it’s absolutely visible.
  6. Take advantage of technology. It could be a medication reminder app or a dedicated digital calendar. Most helpful, set the alarms, esp. smartphone reminders or some cell phones allow you to set multiple alarms a day.
  7. Reduce financial stress by trimming costs down. If your meds cost too much, consult with your pharmacist for a generic brand or current regimen adjustment. In addition, you can switch to a mail-order pharmacy, which certainly offers more savings.
  8. Get help and support from family members, care givers or doctors whenever necessary, e.g. reminder, refilling, or ideas.
  9. Change attitude and take control of your health. Concerns, denials or doubts are real, but none of them is the right solution to your illness. Find a motivation to take that pill, and it should be bigger than you.
  10. When you travel, make sure to take an extra 1-2 days of medications in case of a delayed schedule. Always keep your meds in your carry-on bag. On a similar note, if you’re dining out, take the required meds with you.

The Take-Home-Message:

#1  “Drugs don’t work in patients who don’t take them”. 

#2  Drugs don’t perform well in patients who don’t take them with a right dose, at a right time and in a right way.

#3  Medication adherence can maximize therapeutic benefits. Failure to do so causes considerable health, clinical and economic consequences.

 

Image Credits: Pharmaceuticalonline.com; Lifescript.com

 

Two Critical Matters in Colorectal Cancer Early Detection

By Hui Xie-Zukauskas

Time for cancer screening_Clipart library & CPDAccording to the American Cancer Society (ACS), an estimated 135,430 cases of colorectal cancer (CRC) will be diagnosed and an estimated 50,260 CRC deaths will occur in 2017 in the United States.

Zeroing in on the numbers: within the predicted colorectal cancer incidence, 71,420 will be men and 64,010 will be women, and deaths will be 27,150 among men and 23,110 among women. Consequently in cancer deaths, CRC is the second leading cause in men and the third leading cause in women among Americans. Worldwide, CRC is the third most common cancer.

These numbers make clear that CRC affects both men and women, in contrast to a myth that CRC is primarily a man’s cancer.

The good news is that most colon cancers are preventable! YES!

Yet, why are the statistics so large? Here are two areas many people often ignore or miss:

  •  Lack of adherence to the screening recommendation
  •  Delay in presenting symptoms to a physician/oncologist

Let me weigh in a bit more on each of these issues.

Adherence to screening and the value of colonoscopy

Let’s start with ACS screening guidelines: “Starting at age 50, men and women at average risk for developing colorectal cancer should use one of the screening tests…” This is because about more than 90% of this disease is diagnosed after age 50. For individuals who have a 1st degree family member or relative with colon cancer, exams should start at an earlier age (e.g. ages 40).

One recommended screening test is colonoscopy, because it can not only detect cancers at their earliest, most treatable stages; it can also detect pre-cancerous polyps that can be removed during the exam before they become cancerous.

In reality, 50-60 percent of Americans who are recommended to get screened comply with the guidance. The lower screening rate might partially explain why only about 40 percent of colon cancers are diagnosed at an early stage (i.e. localized in colon or rectum).

Why should you go for a colonoscopy screening?

  1. You gain significant value. Your anxiety, fear, or even feelings of embarrassment may be understandable. However, consider this: Individuals undergo this exam of high quality under a comfortable, sedated condition, during which the entire colon and rectum are visualized by a qualified gastroenterologist. Pre-cancerous polyps can be found and removed safely. Can you see that this is a very valuable package of diagnosis and therapeutics for your colon health care? 
  2. You acquire rigorous clarity concerning your colon health. We want rigorous clarity in science, and surely, everyone wants thorough clarity when purchasing a house or insurance policy. It makes sense to seek rigorous clarity about a matter so critical to your health. If the result is normal, the colonoscopy should be repeated every 10 years up to the age of 75. If the test detects pre-cancerous polyps, the physician will recommend repeating the exam more frequently.
  3. You benefit from one of the most effective cancer prevention methods, and it is often covered by insurance.

Help your physician to help you by presenting any indications

In some cases, especially at an early stage, colon cancer may present no symptoms. Again, that’s why screening is vital to identify cancer early when prognosis and cure are optimistic.

Nevertheless, other folks may experience symptoms such as:

-          Blood in the stool or rectal bleeding

-          Abdominal pain or discomfort

-          Feeling the bowel incompletely empty, or bloating

-          Sudden changes in bowel habits (diarrhea, constipation, or oddly narrow stools)

-          Unexplained fatigue or weakness

-          Unexplained weight loss

Remember, nobody can read what’s on your mind or what’s going on in your life. If you don’t visit or communicate with your doctor, it’s likely he or she won’t know about your cramps or unexplained changes in your bowel movements.

So, devoting yourself to meeting screening guidelines is a key preventive measure, but another critical area is to counsel with your physician about possible warning signs.

In addition, an important step to preventing colorectal cancer is to know its risk factors. These factors can be categorized as:

-          Uncontrolled: age, colon polyps, family or personal history of cancer, esp. CRC

-          Pathological: obesity, diabetes, inflammatory bowel diseases

-          Controllable or Preventable: sedentary lifestyle, tobacco smoking, heavy alcohol consumption, diet with low-fiber but high-fat (esp. animal fats)

To conclude, for colorectal cancer early detection, as for all cancer risks:

#1 Cancer screening is your first crucial preventive step.

#2 Recognizing risk factors and warning signs is your second vital protective weapon.

Image credit: Clipart library & CPD

The Power of Participation in Patient Surveys

By Hui Xie-Zukauskas

Survey-Feedback_CPD w-otherAfter a trip to the doctor, you or a family member may be requested to fill in a “patient satisfaction survey” or “patient experience survey.” Many folks, questioning what difference it would make whether they complete the survey or not, simply ignore it, as if there were more urgent issues in life at the moment. Sound familiar?

In a recent post, I talked about the issue of improving patient safety and quality of care. Well, participating in a patient experience survey is a key part of that issue. Here, I’m going to dive in a little deeper.

First, let’s start with difference between a “patient satisfaction survey” and a “patient experience survey”

Though wordings of the two are similar, a careful assessment reveals striking differences. Understanding these differences can help you collaborate with your providers effectively.

The essential difference between the two is that a patient satisfaction survey concentrates on making patients happy, while a patient experience survey focuses on making people well – beyond making them happy!

A patient satisfaction survey reflects perceptions or preferences of quality of care received, so it’s more subjective. In contrast, a patient experience survey exposes what happened during the care, so is more objective.

Experience reporting is a more reliable instrument because it tells about the patient’s actual experience of a specific service, clinician, or hospital incident. Questions are designed to be more meaningful to patients and more measurable for providers’ care, and the answers can be transformed into actions.

On the other hand, a satisfaction rating is merely a judgment on meeting one’s expectations. As you can understand, people’s expectations vary, and what matters to one person is different for another.

Take a particular example of waiting time:

When asked “How satisfied are you with the waiting time for your appointment” (e.g. setting up time for your visit, finally seeing your doctor), the results from a satisfaction survey could range from excellent through good, fair, and finally poor.

But in a patient experience survey, when asked “How long did you wait for an appointment when you needed care”, the choices are more concrete (e.g., 1 day, 2-3 days, 4-7 days, or longer than 7 days). To the question “How long did you wait to see your doctor”, the answers are specific (e.g., 15 minutes, 15-30 minutes, 30 minutes or longer).

In sum, to steer towards patient-centered care, it is better to ask patients to report their real experience rather than to put down their satisfaction ratings.

Next, how do patients benefit from patient experience surveys?

Patient experience is important because it not only stimulates a strong patient-provider relationship but also is a critical step toward improving quality of care.

In particular,

  1. Patient experience surveys communicate the best way to improve quality of care. Research indicates that improving patient satisfaction has not been linked to improving quality of care.
  2. Emphasizing patient experience means putting patients first, with healthcare providers being concerned more about “what matters to you” rather than “how are we doing”.
  3. Patient experience surveys value patients’ voices. With your voice, an actionable change can begin because your input reveals key indicators for delivering quality of care.

Eventually, greater patient experience will lead to greater quality of care, which will translate into greater patient satisfaction.

Good news for cancer patients ! – CAHPS for Cancer Care

The Agency for Healthcare Research and Quality (AHRQ) has advanced Consumer Assessment of Healthcare Providers and Systems (CAHPS®) to assess quality of care from the patient’s point of view in various healthcare settings.

CAHPS for Cancer Care has been developed by AHRQ to consistently measure and compare cancer care delivered by different providers and ultimately to provide information for quality improvement. CAHPS for Cancer Care includes three separate sets of questionnaires for surgical, radiation, and medical oncology respectively.

Although CAHPS® is the best tool for healthcare providers, patient engagement and participation are important parts of the process. More reasons for this survey, according to Dr. Caren Ginsberg, director of CAHPS® at AHRQ are:

  • CAHPS surveys are featured to capture information about patient experience rather than patient satisfaction;
  • The surveys are scientifically and statistically sound, thus the results are valid and reliable;
  • CAHPS is flexible to use and easily incorporated into any hospital existing surveys. 

Overall, CAHPS® also serves as a massive database that offer measurable and actionable information, as the surveys have been implemented for over 20 years.

How can you participate and cooperate?

As a final point, remember: one survey cannot change health care or save a life, but it represents one voice and constitutes a worthy part of a large set of valuable data. So, when requested next time, please complete the survey (via innovative technology, direct mail, or telephone), because your voice will be heard, and you can help improve healthcare and save lives!

 

Image credit: http://earlylearningwa.org/ and http://knswb.org.au/

Work Together to Reduce Errors in Cancer Diagnosis

By Hui Xie-Zukauskas

Patient engage comm._CPDHave you or your family member ever gotten a wrong diagnosis from your doctor? Have you heard that a doctor treated your friend for a disease or disorder that he/she actually didn’t have? “It is likely that most of us will experience at least one diagnostic error in our lifetime, sometimes with devastating consequences,” according to the experts on diagnostic safety.

Imagine you were diagnosed with breast cancer and went through cancer treatment, then found out the diagnosis was wrong and the treatment should never have happened. That could spell enormous damage from one diagnostic error!

Cancer diagnostic errors can be the most harmful and costly type of diagnostic errors in various ways. As many cancers are complex and multifaceted, a timely and accurate diagnosis for cancer is still often challenging. That adds weight to preventing cancer altogether and urgency to detecting cancer early.

That’s why I bring your attention to this issue: A diagnosis is something that’s done for a patient (you) and the patient (you) needs to be a part of the team in that process.

1.      Basics and facts

What is a “diagnostic error”?

The Institute of Medicine (IOM) defines a diagnostic error as the failure to:

a. Establish an accurate and timely explanation of the patient’s health problem(s); or

b. Communicate that explanation to the patient. 

What is the reality?

40,000 – 80,000 deaths each year are due to diagnostic errors, as reports vary. However, national diagnostic safety experts, Drs. Graber and Schiff, emphasize that the frequency of diagnostic error is in the range of 10%.

Does it sound like misdiagnosis happens far more frequently than you thought?

2.      When does diagnostic error occur and who may be involved?

No doubt, human factors contribute to diagnosis errors. Studies have reported that communication problems are the most frequent root cause of serious events threatening patient safety. Today’s health-care systems are transforming toward not only integrated care practice but also enhanced patient engagement, to this end, everyone is involved.

Let me bring cancer diagnosis to the forefront. A delayed cancer diagnosis may occur at various stages of the journey to fight cancer. It could be a delay in:

  • symptom recognition or interpretation,
  • decision or action to seek medical attention (e.g., putting off making an appointment due to fear or feeling embarrassed),
  • a care system’s scheduling (e.g., not being seen by a doctor in a timely fashion),
  • clinical tests or subsequent consultations, or
  • receiving cancer treatment.

In addition, putting off doing anything might simply be due to lack of insurance coverage.

Here is the key point: Delayed cancer diagnosis at an early stage may leave the cancer to progress or spread, leading to limited treatment options. Thus, a delay in cancer diagnosis can have devastating consequences, including poor clinical outcomes and a lower chance of survival.

3.      How can you help reduce or prevent diagnostic errors?

Here are 15 things you can do to enhance your communication with your doctor, medical care team, and health care system.

1)      Prepare for your visit: know or collect your medical records, medications, and family history.

2)      Remember your screenings and, importantly, follow up. Having a separate calendar can assist your memory.

3)      Always bring a list of questions or at least your top three questions when visiting your physician.

In case you don’t know where to start, Agency for Healthcare Research & Quality provides a list of questions to ask your doctor. You can also generate your own list using their Question Builder. It’s a fantastic tool!

4)      Bring your spouse or a family member to your doctor visit to facilitate communication and/or fill in missing information that might help with diagnosis or treatment.

5)      Use technology (e.g., a smartphone) to record the conversation or instructions.

6)      Feel free to ask the doctor to clarify terminology or procedure. If you don’t understand why a particular question is relevant to your situation, ask about it or let a family member do so.

7)      If you have a limited English proficiency, make sure you have a family member or a friend act as a translator.

8)      Participate in a patient experience survey to improve patient safety and care.

9)      Get involved in facilitating the chain of communication—e.g., in scheduling appointments, visits, follow-ups, and even questioning an insurance billing if you don’t understand it.

10)  Don’t self-diagnose, especially based on online information from an unreliable source.

11)  Do keep a diary or inventory of your symptoms for better recollections when needed.

12)  Seek a second opinion or multiple consultations on cancer diagnosis when in doubt or if necessary. The second opinion must be an expert’s one. Be proactive.

For example, if you have a lump in your breast but get a normal mammogram—after all, mammograms pick up only 80-90% of breast cancer. So, for your safety, you should ask for further screening, e.g., a breast ultrasound (sonogram) or even a test with a higher sensitivity like magnetic resonance image (MRI) to ensure accuracy if your physician doesn’t order such tests.

13)  If diagnosed with cancer, follow up vigorously and treat any referrals to specialists, tests, or care with urgency.

14)  Further the discussion about potentially discrepant diagnosis or different finding.

15)  When you have unintentional weight loss or unexplained pain, take it seriously and see your doctor.

One more point – Misdiagnosis may not be discovered for years if ever in some cases. That’s why I cannot emphasize enough how prevention and early diagnosis of cancer offer clear and significant benefits, especially concerning common cancers (the breast, prostate, colon, lung, and skin cancer).

Although I talked more about cancer, these principles can be applied to any other illnesses. And I’ll elaborate with more details in near the future. Stay tuned.

Finally, your take-home message: Actively engage in your health care!

Improving diagnosis for patient safety and for better health care is a responsibility of each of us. Doing that can alone save many lives.

 

Links between Obesity, Diabetes, and Colon Cancer

By Hui Xie-Zukauskas

Links 3 conditions_CPDColorectal cancer remains the 3rd most common cancer and is the 2nd leading cause of cancer-related deaths in the United States.

The causes of colon cancer are multi-factorial. They include cellular, molecular, and genetic factors, as well as dietary and lifestyle factors. Today, I’m going to focus on one significant yet modifiable risk factor, obesity.

We start with a glimpse at the numbers.

The incidence rate of obesity is alarmingly high among U.S. adults based on CDC data. Rates for different age groups include middle-aged (40.2%), older (37.0%), and younger (32.3%). Also, about 17% of children and adolescents (age 2-19) are obese.

More than 29 million adults and children in the U.S. have diabetes. 86 million Americans have pre-diabetes, a condition that can lead to type-2 diabetes. Note that an estimated one in two seniors has pre-diabetes.

Obesity may be a factor in approximately 300,000 deaths each year. Diabetes will cause an estimated 75,578 deaths and colorectal cancer, an expected 49,190 deaths in 2016.

A look beyond the numbers

Obesity is a leading cause of diabetes, a disease for which the body fails to control blood sugar levels. High blood sugar levels are characteristic of both obesity and diabetes. What is less well known is that diabetes and obesity are also linked to an increase in cancer risk.

In fact, obesity is linked to many types of cancer (colon, esophageal, thyroid, breast, prostate, uterine, kidney, pancreas, gallbladder and non-Hodgkins lymphoma) and, needless to say, heart disease, stroke, and other chronic illnesses.

Research shows that obesity and diabetes are associated with an increased risk of developing colon cancer.

Intrinsic links between obesity, diabetes, and colon cancer are vastly complicated. One clear tie is sugar. High levels of blood sugar are a characteristic in both obesity and diabetes. High blood sugar also makes us predisposed to cancer by increasing the activity of a gene involved in cancer progression. Apparently, dietary sugar is a link tying together obesity, diabetes, and colon cancer, and thus excess sugar has an impact on our risk for cancer.

Certainly, other links play a causal role. For instance, chronic inflammation is a central process that likely leads obese individuals to an elevated risk of diabetes and colon cancer, which all three conditions share a common inflammatory loop participated by multiple cell signaling molecules, growth and nuclear factors.

Highlighted Call for Actions

1. Colon Cancer screening

If you or your loved ones turn 50, you all should begin screening for colorectal cancer and then continue getting screened at regular intervals. This is because colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Colorectal polyps can be found by screening and then removed before they develop into cancers. Plus, any developing cancer can be found earlier by screening when treatment works best.

2. Diabetes Control

Early intervention is critical to preventing or delaying the onset of type-2 diabetes. Good news for our nation’s seniors is that Medicare will extend coverage for pre-diabetes care. Check out the National Diabetes Prevention Program, a preventive health initiative via the Center for Medicare & Medicaid Innovation.

3. Healthy Weight Management

Nutrition and balance diet, weight loss, daily physical activity and healthy lifestyle are all beneficial for keeping weight down. Look for further details in CancerPreventionDaily earlier posts.

In brief, obese people are at a higher risk for developing cancer. Also, an obese condition is often resistant to chemotherapy regimens. The bottom line is that obesity prevention is a key life-saving approach.

 

Image source: CancerPreventionDaily

Care for Deadly Diseases: 10 Strategies to Help You Embrace Your Role

By Hui Xie-Zukauskas

Did you know …

Patient_involve_scripps.orgMore than 560,000 Americans die from cancer each year – more than 1,500 Americans each day.

More than 2,150 Americans die of cardiovascular disease each day – 1 death every 40 seconds.

Nearly 800,000 Americans suffer from a new or recurrent stroke annually – someone has a stroke every 40 seconds and someone dies of a stroke every 4 minutes.

Imagine if you or your loved one had one of these deadly diseases, what kind of care and outcome would you desire?

The Good news is that much effort has been shifting to patient-centered care, with its focus on individual needs. This is different from evidence-based practice that tends to focus on populations. Therefore, high-quality care and a good outcome must now be defined in terms of what is meaningful and valuable to the individual patient.

The Institute of Medicine has identified six areas for quality of care: safety, effectiveness, efficiency, patient-centered care, timely care, and equitable care. As a patient, you are the center of care. That means you need to take an active role in prevention and get involved in your care.

Because we’ve previously covered a great deal about prevention, today I’ll touch on a patient’s role in a high-quality care. And these strategies can extend to many other diseases, including diabetes, Alzheimer’s, obesity and rare diseases.

Here are 10 strategies for getting involved in your healthcare:

1.      Know your critical numbers and results of your screening tests.

These important results include checks for blood pressure, blood sugar and cholesterol levels, mammogram, colonoscopy, bone density scan, and even genetic analysis. These results are valuable for your primary care doctor too.

2.      Tell your story.

Inform the doctor what’s going on with you, in addition to simply answering probing questions from the doctor. Some details of your pain or discomfort may shed light for a correct diagnosis.

3.      Obtain a good primary doctor and a specialist.

Find doctors who have not only reputable professional expertise but also compassion, and who take time to listen to you instead of rushing through routines.

4.      Always have a list of questions in hand when visiting your physician or specialist.

In case you don’t know where to start, WebMD provides essential questions about different conditions. You can also use Question Builder (by Agency for Healthcare Research & Quality) to generate your own questions at http://www.ahrq.gov/apps/qb/  – an excellent tool!

During your visit, if you don’t understand why a particular question is relevant to your situation, ask about it or let a family member do so. You may find that the doctor is only asking the question out of routine. Conversely, you may find out that issues you ignored might actually be very important to your case.

5.      Avoid medical errors, misdiagnoses, and unnecessary tests.

Hospital infections and medical errors kill 400 people each day. So, take safety initiatives to avoid being a victim. Communicate with your doctor if you have questions or concerns. Understand why your procedures or medications are necessary, and understand what will happen if you need surgery. Always keep with you a list of medications you are taking.

6.      Personalized medicine starts with individuals and reflects the patient’s needs, preferences and values.

Let’s face it – different cancers need different treatments; likewise, different patients have different needs. Personalized medicine is characterized as the right treatment for the right person at the right time. It may also encompass a biological therapy that targets specific cells or an interactive approach that requires patients and their physicians to develop customized diet plans and exercise regimes or change unhealthful habits. Remember, you play a key role in transforming your health. So make sure to have proper preventative care.

7.      Be vigilant for new symptoms or concerns, e.g., the occurrence of fever, fall, pain, or swelling.  If you suffer from a serious chronic illness like cancer and have a weak immune system, you are very vulnerable to any infections or inflammations that may worsen your situation. So, take care of your immunizations, and of food and hand hygiene.

8.      Be proactive and active.

This includes choosing a cost-effective health insurance plan and understanding your coverage. It could also be checking out where the nearest Primary Stroke Center is in town in case of a stroke emergency, because time is critical for surviving a stroke! Or volunteer to enroll a clinical trial.

9.      Self-educate, but be mindful of information sources and respect the opinions of your medical team.

Reliable and accurate medical advice can be difficult to determine sometimes on the Internet. Medical issues can involve life and death! Respect and trust your physicians, because as in life, sometimes what you think you want may not be what you really need. For instance, maybe what you want is an unnecessary drug, but what you really need is the right information or modification of your behavior. So, don’t measure good care by merely meeting your desires.

10.  Get family and friends involved.

Remember: Your health care is teamwork. Although you need to take ownership and get in the “driver’s seat,” you are not alone; your physicians, care professionals and care givers, the healthcare system, and your loved ones all take the ride with you.

Finally, being empowered with these principles and embracing your active role will facilitate the high-quality, patient-centered care that your medical professionals strive for. And they will help you achieve a desirable clinical outcome, leading to better health and more happiness for you and your family.

 

Image credit: scripps.org