patient education

The treatment options for people with vision problems have changed dramatically over the past decade. New technologies have improved outcomes, reduced patient discomfort and brought an unprecedented level of choice for patients. We spoke with Dr Kaweh Schayan-Araghi, a consultant ophthalmologist at Artemis Klinik in Germany, about the progress he has witnessed and what the future may hold. How have treatment options changed for your patients? Over last ten years or so, the treatments available have improved for people with myopia (short-sightedness), astigmatism (defect in the eye resulting in distorted images), and cataract (a clouding of the lens). Looking back, the options for patients with astigmatism were especially few for those with low or moderate astigmatism – interocular lenses were really only used for people with much higher astigmatism and it was quite difficult to get a precise correction. Limbal relaxation incision was also used to correct astigmatism. This involves cutting into the cornea but, to be frank, the outcome was quite unpredictable and uncomfortable for patients. Most endured itching, rubbing and a feeling that there was something in their eye for three or four weeks. What is available today? The most dramatic change has been the evolution from implanting just clear lenses to implanting a refractive lens which actually corrects vision: we are now addressing cataracts and correcting vision in a single surgery. This would previously have required two separate operations. So, in a lot of cases we are not just clearing the cataract, the patient could be rid of glasses or have reduced dependency on glasses for the first time in decades. What kind of attitudinal shift have you seen in ophthalmology? In the past, the goal of surgery was to improve ‘best corrected vision’. This implies that patients continue to wear glasses. Today, surgeons want to achieve...
Shouldn’t we be rewarded for healthy behaviour rather than repeatedly punished for being ‘bad’? Fat tax and sugar tax, duty on cigarettes and vodka – everyone can think of a ‘sin tax’ they pay from time to time. These are the penalties we pay for making unhealthy choices. The idea of sin taxes has been gaining ground in recent years. The success of price rises on cigarettes and alcohol in curbing consumption is leading governments to consider what other disease-causing products could be taxed out of existence . In Europe, Denmark were the early movers: they introduced a tax on fatty foods in 2011. It applied to meat, dairy products, oils and certain other foods which contained more than 2.3% of saturated fat. The tax ‘worked’ in that it raised revenue and cut consumption of fatty foods by 4% . However, the policy didn’t last long. It was scrapped within 18 months because the government said the tax was too difficult and expensive to collect. Japan is taking a different route . Instead of hitting shoppers in the pocket to reduce the size of their gut, authorities impose fines on employers and local governments who fail to keep waistlines in check. Other countries, including the UK and Ireland have targeted sugary drinks by proposing a ‘soda tax’ to nudge consumers into making healthier choices. Celebrity chef Jamie Oliver – a campaigner for healthy eating – hailed the move as a victory for children’s health. He was so happy about the new tax that he did a little dance at the end of a TV interview which was captured by BBC! There’s no doubt that taxes can be used to push people into making ‘better’ choices. But what ever happened to incentives for positive change? GPs in the UK get bonuses...
Childhood obesity is increasing, particularly in low- and middle-income countries. In high–income countries, while prevalence may be plateauing, it remains high; and we are seeing an increase among children living in disadvantage. In January 2016, a report by the World Health Organisation’s Commission on Ending Childhood Obesity called for prevention efforts to target early life, specifically three critical periods: preconception and pregnancy, infancy and early childhood and older childhood and adolescence. An early-life focus is important because the health and social impact of excess weight and obesity in childhood persists into later stages of life, negatively affecting health, educational attainment and general life quality. Current high rates of childhood obesity are the product of a perfect early-life storm. Understanding the combination of factors that put children living in disadvantage at risk of obesity provide a clear focus for public health action. A perfect storm More children are now growing up in societies that facilitate weight gain and obesity by creating environments where a healthy choice is not the cheapest or the easiest option. Our recent review identified a range of factors likely to influence a child’s increased weight gain. These include maternal factors, prior to and during pregnancy. Diet, smoking, being overweight or obese when becoming pregnant, gaining excess weight during pregnancy and developing gestational diabetes can all increase the risk of the child being overweight. A father being overweight or obese at conception is also a risk for the child’s future weight. In the early months and years of a child’s life, many factors pose a risk to becoming overweight. These include the child not being breastfed or being breastfed for too short a time. A child’s risk of obesity is also strongly affected by the diet they learn to enjoy from the start of life, so early food...
What is your day-to-day work like? How do you help improve or save people's lives through your work? I am in charge of a home dialysis program in Helsinki. In my department, we take care of the education and training of patients to prepare them for therapy. In Finland, we have been active in this field from the early 80s. There are about 500 dialysis patients in our hospital district, 35% of whom are treated at home. We believe that home therapy is best for the patients. It does not only provide the best quality of life and outcomes, but it also allows for the treatment to be more personalised. It is in fact a win-win-win: for patients to be able to recover at home and get the best treatment, for healthcare professionals to be able to deliver the best care with limited staff and for society in terms of costs to the economy and healthcare. From early on, patients are able to choose the treatment best suited to them, thanks to the information available to them. It is important to not only provide this information to the patients, but also to their family. What do you think are the top three challenges facing the healthcare system and your profession in particular? One of the biggest challenges is the ageing population and the growing number of patients with end-stage renal failure. In the meantime, resources such as money or healthcare staff are lacking in order to balance the demands on the system. Finally, we should be up to date about technological and medical developments in our respective fields. The world is changing and we need to be able to adapt to these changes and understand the new demands. What role do you see for medical technologies to address these challenges?...
Question: As an active leader in the heart failure conversation and the instigator of the Heart Failure Aware campaign, could you tell us more on what it’s trying to achieve, target, why is it important, and how you could see it rolled out across Europe? Currently we are facing a number of large unmet challenges in heart failure across Europe. There is no parity in access to care, variations exist across Europe; I say this because we know what we should be doing, but we’re not doing it. 15 million people in Europe have heart failure; it’s a tsunami that will hit the shores of Europe’s health systems, it’s not on the agenda – politically, economically or even amongst the public. It is a poor relation in comparison to other conditions. One of the challenges we face includes a lack of access to innovation across all therapeutic areas in heart failure. Patients when diagnosed aren't generally aware of the therapy options and pathways. Heart failure patients don't know until they have been managing their condition for a long time, of the treatment options potentially available to them such as cardiac devices. Awareness of medtech products and therapies is very low in the heart failure patient community, and it’s even worse around the innovations. The reason I founded the Pumping Marvellous Foundation was because patients and their families were under-served and were in need of knowledge, information and techniques to manage their heart failure – and an essential element to this is knowing what is available, our patient community call this ‘hope’. We developed a heart failure community platform on Facebook because it was free and social media plays a big part in people's lives. Recent studies have suggested, that our assumptions around older persons use of social media is wrong,...
For several years now, the Global Initiative for Asthma (GINA) has maintained the same theme for World Asthma Day: “You Can Control Your Asthma”. It is an empowering message for people living with asthma, one of Europe’s major chronic diseases affecting 30 million citizens, of which 6 million live with severe asthma symptoms. Asthma is a demanding disease and its control remains a challenge for many patients. It requires discipline to properly follow treatment; flexibility to cope with the disease and its symptoms; and proper education to know the right things to do when facing an asthma attack. But how can we ask a child with asthma to have such a degree of self-awareness at such a young age? At EFA – the European Federation of Allergy and Airways Diseases Patients' Associations - we have conducted a new research on the factors driving adherence to treatment among young people with asthma from 12-17 years old. Surprisingly, many of the patients we interviewed said they do not follow their asthma treatment because sometimes they forget their medication. Others rebel against medical advice or skip their treatment as a reward when they feel better. These behaviors on a continued basis impact asthma control and health status. The good news, however, is that young people with asthma trust their doctors and this trust can be built upon. I think the application of technologies to the self-management of respiratory diseases like asthma is our best option to help young patients cope with and take charge of their disease. I am involved through EFA in myAirCoach , an EU-funded project, where a group of healthcare professionals, researchers, engineers, medical devices companies and volunteering patients is developing an mHealth tool to help people living with asthma predict the progression of their disease. To me, mHealth tools...

Isabel Proaño

The European Federation of Allergy and Airways Diseases Patients' Associations (EFA)...