Integrative medicine: A Patient-Centered Approach
Integrative medicine couples conventional and complementary therapies that put the patients at the centre of the active healing process, aiming to empower the patient to take an active part of the healing process.
This patient-centred approach has been used for ages, though it has grown since the 90s: the patient is well informed and therefore empowered to take their own medical decisions, they are encouraged to manage their own therapies. It addresses a full range of care, physical comfort and emotional support, based on the understanding of how patients see their illnesses as well as their cultural beliefs. Being centred on patients does not mean that practitioners relinquish their control, but rather that they find common ground to understand patients and better match their unique needs.
This medicine also acts upstream as it understands and applies principles relating to prevention of diseases and behavioral changes appropriate to different populations.
The patient-centred approach includes six interactive components:
- practitioners explore not only patients’ diseases, but also how the patient is dealing with the disease: in particular the feeling of being ill, ideas on what is wrong with them, the impact of the disease on their daily lives and their expectations on what should be done
- understanding the person in his or her subjective, personal and psychosocial globality
- agreeing with patients on problems, solutions and how responsibilities should be shared
- highlighting prevention of diseases and promoting health
- establishing and maintaining the practitioner-patient relationship
- being realistic in their approach.
What integrative medicine brings into patient-centred medicine
Patient driven Integrative medicine seeks to create a healthcare system including patient centred medicine, it gives priority to self-care and empowerment, reaffirms the patient-practitioner therapeutic relationship and liaises conventional medical systems and alternative medical systems.
Patients care and empowerment of patients are the main components, together with the commitment to include spiritual, mental, and social aspects of health.
Integrative medicine, as an emerging medical domain, liaises conventional medical systems and alternative medical systems and find therapeutic resources which are profitable, combining them to have “the best of both worlds”, whilst maintaining the integrity of each system..
The nine principles of integrative medicine – Whitestone Foundation
Reminder of medical and economic assessment bases
A medical and economic assessment is an economic assessment applied to the realm of healthcare. It can be defined as a comparative analysis of the various diagnostic, therapeutic or preventive strategies, based on their costs and the results they give. The aim of a medical and economic assessment is to find efficiency in determining which strategies produce the best health benefits per monetary unit invested.
These are the main tools that decision-makers use when deciding whether or not to repay medical services.
A medical and economic assessment brings information on innovation in terms of effectiveness in use after a given innovation has been clinically validated. It thus comes after the clinical research stage that aims to assess the effectiveness and safety of an innovation.
KEY STAGES IN MEDICAL AND ECONOMIC ASSESSMENT
A medical and economic assessment generally included the following key steps.
Methodological aspects of the economic assessment
The first one consists in selecting the structuring methodological aspects for the economic assessment, meaning:
- The assessment method: this choice depends on the type of consequences to be considered (quality of life, length of life, etc.), and thus the indicator of the result retained.
- The forecast of a point of view to be retained (patient, hospital, health insurance, society, etc.), to define costs and their scope: who pays?
- The population to be analysed: an aggregate of individuals whose health has been directly or indirectly impacted by interventions.
- Interventions to be compared: identifying all rival interventions for the innovation being studied. The choice of comparators varies according to the context. More often than not, it is the reference method, however the “do nothing” option is conceivable.
- The time-frame: the length of the study must encompasse the principle effects of strategies being assessed in terms of costs and consequences. Costs and consequences are studied during the same time-frame.
- The discounting method: it allows costs and consequences to be compared throughout the years. This reflects the fact that cost and consequences will not have the same value in the present and in the upcoming years.
- Carrying out a systematic data review in published articles.