A local community health worker service in Boston could be the key to improving holistic care for patients.
A Prevention and Access to Care and Treatment programme (PACT), in Greater Boston helps HIV patients like Kenya Jackson by accompanying them to their medical appointments, working through their psychosocial issues and assisting them to take their medication.
The programme, run by the non-profit organisation Partners in Health, has a team of six trained community health workers that are not professional doctors, nurses or therapists. They aim to motivate, guide and provide practical solutions for patients who will be encouraged to manage their own healthcare. Moreover, PACT and the Fenway Institute, another community health worker provider, recognise the value that this holistic service could have for other patient populations in Boston and so plan to expand to patients with chronic diseases and those at risk of getting HIV.
Prior to PACT, Jackson was homeless for several years, depressed about his HIV diagnosis and failed to take his drugs regularly. Now, after year-long programme of daily social support, Jackson lowered his HIV infection levels. In addition, he continues to take his medication regularly as well as visiting dialysis three times a week and keeping his medical appointments. His success demonstrates how valuable holistic care can be in improving patient adherence and confidence in treatment.
While the PACT programme is better associated with poorer patients and their complex needs, their services could also be useful for the general patient population. For instance, due to the amount of medication that many patients need to consume, adherence to treatment can become a major issue. To help Jackson with his adherence problem, PACT worked with doctors to package his pills in single-dose blister packs that could be carried discreetly. This also meant that Jackson did not have assemble his daily doses himself which, was often time-consuming and prone to errors due to the large amount of HIV medication.
Additionally, Jackson states that it was the daily social support that encouraged him to manage his healthcare better. Doctors, due to their time constraints, cannot always offer this holistic form of encouragement for the patient meaning that this social support needs to come from elsewhere in the healthcare industry.
Furthermore, while 90% of US adults like the idea of a digital health service, most patients still value face-to-face time with doctors and other care providers. So, following the initial prescription for an illness, doctors could refer patients to services like PACT to ensure that better, long-term, face-to-face healthcare management which reduces the pressure on primary care services. Perhaps, Jackson’s adherence to his treatment was helped by a familiar face in the form of PACT community care worker Gregory Jules who consistently helped Jackson improve his quality of life.
The pharmaceutical industry could benefit from a collaborative effort with this non-medical, holistic, community service. They could learn how to minimise non-adherence through sponsored community care programmes as well as monitor long-term treatment management in real life which could be used to develop drugs and treatment plans that are necessary and not just appropriate for a patient.
The PACT healthcare scheme which focuses purely on holistic, emotional care for the patient is useful in allowing the patient to maintain a reasonable quality of life even after being diagnosed with a life-changing illness. It recognises that while adherence to treatment advice offered by health professionals on a regular basis is important, patients should be empowered to manage their own healthcare. If this holistic element is used within the current healthcare system, better care for all patients can be guaranteed and not just promised.
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