The current chronic disease management often focuses on achieving goal values for HbA1c, blood pressure, LDL cholesterol, or eGFR. One should not completely rely on these figures as they serve their purpose for a treatment guide and do not accurately represent how well the patient is doing or behaves.
Clinicians may inadvertently foster polypharmacy, overtreatment, and, to a certain extent, may also be responsible for a lower quality of life in their pursuit of “perfect targets”, particularly in the geriatric population or those with multiple comorbidities. Sometimes, the lab assessment results happen to be perfect on paper but can obscure symptoms, preferences, and everyday functioning.
A balance is required between evidence-based targets and individualized goals, shared decision-making, and timely medication reviews. This balance depicts true patient-centred care.
When numbers improve but the patient doesn’t, is it time to rethink how we define treatment success?
MBH/AB