May 14, 2024 | Michael J. Goldfarb, MD, MSc; Martha Abshire Saylor, PhD, RN; Bykem Bozkurt, MD, PhD; Jillianne Code, PhD; Katherine E. Di Palo, PharmD, MBA, MS, FAHA; Angela Durante, PhD, RN; Kristin Flanary, MA; Ruth Masterson Creber, PhD, MSc, RN; Modele O. Oggunyiji, MD, MPH, FAHA; Fatima Rodríguez, MD, MPH, FAHA; Martha Gulati, MD, MS, FAHA, Vice Chair; on behalf of the American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Hypertension; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; and Council on Quality of Care and Outcomes Research
AHA Scientific Statement: Patient-Centered Adult Cardiovascular Care
Patient-centered care is increasingly recognized as a goal of high-quality health care delivery. It involves respecting patients' beliefs, preferences, and values, and fostering shared decision-making that aligns with their goals. This scientific statement outlines the role and impact of patient-centered care in adult cardiovascular medicine, emphasizing shared decision-making, collaborative care, patient-oriented medication management, and patient-reported outcomes. It also highlights challenges in implementing patient-centered care and strategies to overcome them.
Shared decision-making is a key component of patient-centered care, involving a collaborative partnership between clinicians, patients, and families. It leads to improved patient knowledge, self-efficacy, and health outcomes. Technology, telemedicine, and digital communication platforms facilitate shared decision-making and help address health disparities.
Collaborative care involves a multidisciplinary team providing timely, comprehensive, and personalized care. It is particularly beneficial for individuals with complex conditions or from underrepresented groups. Patient-centered medication management requires individualized approaches, considering patient-related and drug-related factors. Tools like the Screening Tool of Older People's Prescriptions and The Beers List help identify inappropriate medications for deprescribing.
Patient-centered care must address structural determinants of health, including social determinants of health (SDOH), to improve outcomes for underrepresented populations. Cultural competency and implicit bias training are essential for health care professionals to provide equitable care. Addressing disparities in cardiovascular care requires a health equity lens, especially for historically underrepresented groups.
Older adults and women require special attention in patient-centered care, with considerations for frailty, dementia, and unique health needs. Individuals with behavioral and mental health disorders benefit from integrated behavioral health care. Adults with congenital heart disease and those with physical disabilities also require tailored care approaches.
Patient-reported outcomes (PROs) provide a global perspective on health status and are essential for informed decision-making. PROs can be integrated into electronic health records (EHRs) to guide clinical decisions and improve care. Challenges in implementing patient-centered care include barriers at the patient, clinician, and system levels, as well as disparities in access to care.
Practical strategies to promote patient-centered care include clear communication, shared decision-making, and incorporating patient preferences into care planning. Technologies like AI and wearable devices have the potential to enhance patient-centered care, but their effectiveness must be validated. Telemedicine is increasingly used in cardiovascular care, but digital literacy and broadband access must be addressed to ensure equitable access.
The statement emphasizes the need for education on patient-centered care in medical training and the importance of incorporating patient values into clinical practice. It calls for national stakeholders to shift from traditional metrics to a more patient-centered approach. Ultimately, patient-centered care should be central to any measure of success in cardiovascular care.AHA Scientific Statement: Patient-Centered Adult Cardiovascular Care
Patient-centered care is increasingly recognized as a goal of high-quality health care delivery. It involves respecting patients' beliefs, preferences, and values, and fostering shared decision-making that aligns with their goals. This scientific statement outlines the role and impact of patient-centered care in adult cardiovascular medicine, emphasizing shared decision-making, collaborative care, patient-oriented medication management, and patient-reported outcomes. It also highlights challenges in implementing patient-centered care and strategies to overcome them.
Shared decision-making is a key component of patient-centered care, involving a collaborative partnership between clinicians, patients, and families. It leads to improved patient knowledge, self-efficacy, and health outcomes. Technology, telemedicine, and digital communication platforms facilitate shared decision-making and help address health disparities.
Collaborative care involves a multidisciplinary team providing timely, comprehensive, and personalized care. It is particularly beneficial for individuals with complex conditions or from underrepresented groups. Patient-centered medication management requires individualized approaches, considering patient-related and drug-related factors. Tools like the Screening Tool of Older People's Prescriptions and The Beers List help identify inappropriate medications for deprescribing.
Patient-centered care must address structural determinants of health, including social determinants of health (SDOH), to improve outcomes for underrepresented populations. Cultural competency and implicit bias training are essential for health care professionals to provide equitable care. Addressing disparities in cardiovascular care requires a health equity lens, especially for historically underrepresented groups.
Older adults and women require special attention in patient-centered care, with considerations for frailty, dementia, and unique health needs. Individuals with behavioral and mental health disorders benefit from integrated behavioral health care. Adults with congenital heart disease and those with physical disabilities also require tailored care approaches.
Patient-reported outcomes (PROs) provide a global perspective on health status and are essential for informed decision-making. PROs can be integrated into electronic health records (EHRs) to guide clinical decisions and improve care. Challenges in implementing patient-centered care include barriers at the patient, clinician, and system levels, as well as disparities in access to care.
Practical strategies to promote patient-centered care include clear communication, shared decision-making, and incorporating patient preferences into care planning. Technologies like AI and wearable devices have the potential to enhance patient-centered care, but their effectiveness must be validated. Telemedicine is increasingly used in cardiovascular care, but digital literacy and broadband access must be addressed to ensure equitable access.
The statement emphasizes the need for education on patient-centered care in medical training and the importance of incorporating patient values into clinical practice. It calls for national stakeholders to shift from traditional metrics to a more patient-centered approach. Ultimately, patient-centered care should be central to any measure of success in cardiovascular care.