Have you ever had the experience of a serious medical diagnosis and wondered if a) this means the end, b) you need to take this seriously, or c) it will go away? Your brain definitely goes into overload!

Recently, I had an episode in hospital where I was diagnosed with cardiomyopathy. I was admitted via the emergency room of my local hospital because I was struggling to breathe. In truth, I felt I was drowning and it was genuinely scary.

Cardiomyopathy is a serious disease in which the heart muscle becomes inflamed and doesn’t work as well as it should. It is the result of a weakening in the actual heart muscle. My doctor tells me I will need to take medication for the rest of my life and he will need to regularly monitor my heart over the next few months.

How did it make me feel? Honestly? The truth is I was not sure and terrified all in the one breath. I no longer had the shortness of breath but what did this new quietness mean? It’s almost like you are glued to the one spot for fear of upsetting the apple cart.

Then the most amazing thing happened. When I returned home, I had a phone call from my health insurer. They noticed that I had recently been in hospital with heart failure and asked me “if I was interested in some coaching for the next six months to help me get back on track with my heart?” I leapt at it. And I suddenly had warm and fuzzy thoughts about my health insurer as a partner in life!

In my case, the coaching support involves regular telephone calls with a dietician. The purpose of it is to work out a plan of action, support its implementation and monitor its success. We look at things like fluid in the body, diet, salt intake and exercise. The dietician has access to my medical records, blood test results and the results of other tests such as electrocardiograms and echocardiograms.

This new program is keeping me on the straight and narrow. A friend of mine told me the other day that she had had a similar experience with her health insurer after she was diagnosed with breast cancer. Like mine, the intention of her program is to avoid re-hospitalisation, a huge cost to both the private and the public health care system.

The reality is that self-management helps in the treatment of chronic illnesses, such as diabetes, heart disease, arthritis, lupus and chronic obstructive pulmonary disease. Although successful treatments are available for these conditions, people are not quite so good at sticking to the plan. This means that the rate of compliance with –

•     taking medication,
•     making changes to your diet,
•     increasing physical activity,
•     monitoring your blood test results,
•     reducing your alcohol intake, or
•     attending regular medical screenings,

– is reported to be only around 50%.

Various studies on this type of self-management have focused on the health professional as a coach. Coaching has been defined as an interactive role carried out by a health professional to support a patient to be an active participant in the self-management of a chronic illness.

A review of the literature shows that community-based interventions have a vital role in self-management of a chronic disease. The role of the coach in assisting behaviour change was also shown to be a significant factor. However, not everybody is ready for change. This is where the role of the coach really comes into play, to help a patient move forward. There is evidence that this works, as is the importance of taking into account the emotional state of the patient.

The challenge for future research is to look into the relative strengths of these coaching approaches to support patient self-management of chronic illness. Researchers then need to find the best ways of integrating these approaches into routine health care, through a wide range of health professionals.

Now we have the evidence to support the success of this type of intervention, we need to be looking at how other injuries might be successfully managed this way. Imagine if we had this type of support to manage a back injury or a traumatic injury in the workplace. Preventative health certainly offers a cure for many of our overworked return-to-work coordinators who are juggling a million things at once.