Treating Non-Communicable Diseases (NCDs): Beyond Medication Prescription - A Case Series

Abstract

Conventional care of NCDs primarily focuses on a biological approach via pharmacological intervention, often disregarding the patient’s needs. Not only has this contributed to an increased economic burden, adherence rate among patients and satisfaction rate among clinicians have also been abysmal. Most clinicians believe lifestyle and psychological approaches are impractical due to the time constraint in their busy clinics. This case series aims to examine the feasibility and preliminary efficacy of a patient centred model based on psychological approaches in managing patient with NCDs in a primary care setting. This write up is a case series involving 5 gentlemen with military background, ages between 34 to 66 years old with 2 to 5 NCD diagnosis. All cases were seen by a military family medicine specialist, trained in motivational interviewing. Patients were empowered to practice a healthy lifestyle and their challenges were addressed at every visit. The average duration of follow up was 20 months. Marked improvements were seen in fasting blood glucose, HbA1c level, blood pressure, triglycerides, high density lipoprotein, low density lipoprotein and alanine transaminase. All patients were able to reduce their weight and medication. Patients reported better quality of life and ability to sustain their healthier lifestyle change. This article hopes to explore the idea of de-prescribing as an essential effort in supporting lifestyle change.