Patient involvement: a vital principle for patient-centred health care.

Chronic conditions account for over half of the global disease burden (WHO, 2004) and is predicted to continue to rise. This is placing an ever-increasing burden on health systems, originally designed to address acute medical conditions. In order to cope with the continuing increase in the number of patients with chronic conditions, health systems need to develop so that they are able to address the ongoing needs of these people. This requires a different approach because chronic conditions, such as diabetes, heart disease, asthma and cancer, require management on an ongoing basis, often for many years or decades. Health systems therefore require the personal involvement and commitment of the patient to adhere to their treatment and make behavioural changes if they are to effectively manage their health care. There is growing evidence that designing health systems with the patient at the centre--patient-centred health care--is an appropriate way to address the needs of people with chronic conditions. The benefits are that it promotes greater patient responsibility and optimal usage which ultimately leads to improved health outcomes, quality of life and patient satisfaction (see Box 1). Patient-centred health care, achieved through patient involvement in health policy, will help ensure that the health system is designed to address the needs of patients making it possible for them to be meaningfully engaged in their personal care and effectively manage their condition.