What Are “Adaptogens” Anyway? (And Other Questions Answered)

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It’s Q&A Day at 10almonds!

Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

So, no question/request too big or small

❝I tried to use your calculator for heart health, and was unable to enter in my height or weight. Is there another way to calculate? Why will that field not populate?❞

(this is in reference to yesterday’s main feature “How Are You, Really? And How Old Is Your Heart?“)

How strange! We tested it in several desktop browsers and several mobile browsers, and were unable to find any version that didn’t work. That includes switching between metric and imperial units, per preference; both appear to work fine. Do be aware that it’ll only take numerical imput, though.

Did anyone else have this problem? Let us know! (You can reply to this email, or use the handy feedback widget at the bototm)

❝I may have missed it, but how much black pepper provides benefits?❞

So, for any new subscribers joining us today, this is about two recent main features:

As for a daily dosage of black pepper, it varies depending on the benefit you’re looking for, but:

  • 5–20mg of piperine is the dosage range used in most scientific studies we looked at
  • 10mg is a very common dosage found in many popular supplements
  • That’s the mass of piperine though, so if taking it as actual black pepper rather than as an extract, ½ teaspoon is considered sufficient to enjoy benefits.

❝I loved the health benefits of pepper. I do not like pepper. Where can I get it as a supplement?❞

You can simply buy whole black peppercorns and take a few with water as though they were tablets. Your stomach acid will do the rest. Black pepper is also good for digestion, so taking it with a meal is best.

You can buy piperine (black pepper extract) by itself as a supplement in powder form, but if you don’t like black pepper, you will probably not like this powder either. We couldn’t find it readily in capsule form.

You can buy piperine (black pepper extract) as an adjunct to other supplements, with perhaps the most common/popular being turmeric capsules that also contain 10mg (or more) piperine per capsule. Shop around if you like, but here’s one that has 15mg piperine* per capsule, for example.

*They call it “Bioperine®” but that is literally just piperine. Same goes if you see “Absorbagen™”, it’s still just piperine.

❝What do you mean when you say that something is adaptogenic?❞

Simple version: it means it helps the body adapt to stress, by adjusting the body’s natural responses. Thus, adaptogenic supplements can be contrasted with tranquilizing drugs that mask stress by brute force, for example.

Technical version: adaptogenic activity refers to improving physiological stress resilience, such as by moderating and modulating hypothalamic–pituitary–adrenal axis signaling, and/or by regulating levels of endogenic compounds involved in the cellular stress response.

Read more (technical version):

Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity

Read more (simple version):

European Medicines Agency’s Reflection Paper On The Adaptogenic Concept

Enjoy!

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  • Tasty Hot-Or-Cold Soup

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Full of fiber as well as vitamins and minerals, this versatile “serve it hot or cold” soup is great whatever the weather—give it a try!

    You will need

    • 1 quart low-sodium vegetable stock—ideally you made this yourself from vegetable offcuts you kept in the freezer until you had enough to boil in a big pan, but failing that, a large supermarket will generally be able to sell you low-sodium stock cubes.
    • 2 medium potatoes, peeled and diced
    • 2 leeks, chopped
    • 2 stalks celery, chopped
    • 1 large onion, diced
    • 1 large carrot, diced, or equivalent small carrots, sliced
    • 1 zucchini, diced
    • 1 red bell pepper, diced
    • 1 tsp rosemary
    • 1 tsp thyme
    • ¼ bulb garlic, minced
    • 1 small piece (equivalent of a teaspoon) ginger, minced
    • 1 tsp red chili flakes
    • 1 tsp black pepper, coarse ground
    • ½ tsp turmeric
    • Extra virgin olive oil, for frying
    • Optional: ½ tsp MSG or 1 tsp low-sodium salt

    About the MSG/salt: there should be enough sodium already from the stock and potatoes, but in case there’s not (since not all stock and potatoes are made equal), you might want to keep this on standby.

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat some oil in a sauté pan, and add the diced onion, frying until it begins to soften.

    2) Add the ginger, potato, carrot, and leek, and stir for about 5 minutes. The hard vegetables won’t be fully cooked yet; that’s fine.

    3) Add the zucchini, red pepper, celery, and garlic, and stir for another 2–3 minutes.

    4) Add the remaining ingredients; seasonings first, then vegetable stock, and let it simmer for about 15 minutes.

    5) Check the potatoes are fully softened, and if they are, it’s ready to serve if you want it hot. Alternatively, let it cool, chill it in the fridge, and enjoy it cold:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • One More Resource Against Osteoporosis!

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Your Bones Were Made For Moving Too!

    We know that to look after bone health, resistance training is generally what’s indicated. Indeed, we mentioned it yesterday, and we’ve talked about it before:

    Resistance Is Useful! (Especially As We Get Older)

    We also know that if you have osteoporosis already, some exercises are a better or worse idea than others:

    Osteoporosis & Exercises: Which To Do (And Which To Avoid)

    However! New research suggests that also getting in your recommended 150 minutes per week of moderate exercise slows bone density loss.

    The study by Dr. Tiina Savikangas et al. looked at 299 people in their 70s (just over half being women) and found that, over the course of a year, bone mineral density loss was inversely correlated with moderate exercise as recorded by an accelerometer (as found in most fitness-tracking wearables and smartphones).

    In other words: those who got more minutes of exercise, kept more bone mineral density.

    As well as monitoring bone mineral density, the study also looked at cross-sectional area, but that remained stable throughout.

    As for how much is needed:

    ❝Even short bursts of activity can be significant for the skeleton, so we also looked at movement in terms of the number and intensity of individual impacts. For example, walking and running cause impacts of different intensities.

    We found that impacts that were comparable to at least brisk walking were associated with better preservation of bone mineral density.❞

    ~ Dr. Tiina Savikangas

    Read more: Impacts during everyday physical activity can slow bone loss ← pop-science source, interviewing the lead researcher

    On which note, we’ve a small bone to pick…

    As a small correction, the pop-science source says that the subjects’ ages ranged from 70 to 85 years; the paper, meanwhile, clearly shows that the age-range was 74.4±3.9 years (shown in the “Results” table), rounded to 74.4 ± 4 years, in the abstract. So, certainly no participant was older than 78 years and four months.

    Why this matters: the age range itself may be critical or it might not, but what is important is that this highlights how we shouldn’t just believe figures cited in pop-science articles, and it’s always good to click through to the source!

    Read the study: Changes in femoral neck bone mineral density and structural strength during a 12-month multicomponent exercise intervention among older adults – Does accelerometer-measured physical activity matter?

    This paper is a particularly fascinating read if you have time, because—unlike a lot of studies—they really took great care to note what exactly can and cannot be inferred from the data, and how and why.

    Especially noteworthy was the diligence with which they either controlled for, or recognized that they could not control for, far more variables than most studies even bother to mention.

    This kind of transparency is critical for good science, and we’d love to see more of it!

    Want to apply this to your life?

    Tracking minutes-of-movement is one of the things that fitness trackers are best at, so connect your favourite app (one of these days we’ll do a fitness tracker comparison article) and get moving!

    And as for the other things that fitness trackers do? As it turns out, they do have their strengths and weaknesses, which are good to bear in mind:

    Thinking of using an activity tracker to achieve your exercise goals? Here’s where it can help—and where it probably won’t

    Take care!

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  • Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death

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    In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades.

    Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common.

    You can read articles listing the seven cities you must visit before you die or the 100 Australian bucket-list travel experiences. https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&start=0

    But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret.

    The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness.

    In a study published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel.

    Why is travel so important?

    There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important life transitions: the youthful gap year, the journey to self-discovery in the 2010 film Eat Pray Love, or the popular figure of the “grey nomad”.

    The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams.

    Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans:

    We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed.

    For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse:

    So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend.

    People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland.

    Humpback whale breaching off the coast
    Whale watching in Queensland was on one person’s bucket list. Uwe Bergwitz/Shutterstock

    Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement:

    In the last three years, I think I’ve lived more than a lot of 80-year-olds.

    But travel is expensive

    Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire.

    Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true.

    But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us:

    We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind.

    Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet.

    Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said:

    This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel.

    Something we ‘ought’ to do?

    Bucket lists are also a symptom of a broader culture that emphasises conspicuous consumption and productivity, even into the end of life.

    Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “ought” to do.

    Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey.

    Names of study participants mentioned in this article are pseudonyms.

    Leah Williams Veazey, ARC DECRA Research Fellow, University of Sydney; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney, and Katherine Kenny, ARC DECRA Senior Research Fellow, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Evidence doesn’t support spinal cord stimulators for chronic back pain – and they could cause harm

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In an episode of ABC’s Four Corners this week, the use of spinal cord stimulators for chronic back pain was brought into question.

    Spinal cord stimulators are devices implanted surgically which deliver electric impulses directly to the spinal cord. They’ve been used to treat people with chronic pain since the 1960s.

    Their design has changed significantly over time. Early models required an external generator and invasive surgery to implant them. Current devices are fully implantable, rechargeable and can deliver a variety of electrical signals.

    However, despite their long history, rigorous experimental research to test the effectiveness of spinal cord stimulators has only been conducted this century. The findings don’t support their use for treating chronic pain. In fact, data points to a significant risk of harm.

    What does the evidence say?

    One of the first studies used to support the effectiveness of spinal cord stimulators was published in 2005. This study looked at patients who didn’t get relief from initial spinal surgery and compared implantation of a spinal cord stimulator to a repeat of the spinal surgery.

    Although it found spinal cord stimulation was the more effective intervention for chronic back pain, the fact this study compared the device to something that had already failed once is an obvious limitation.

    Later studies provided more useful evidence. They compared spinal cord stimulation to non-surgical treatments or placebo devices (for example, deactivated spinal cord stimulators).

    A 2023 Cochrane review of the published comparative studies found nearly all studies were restricted to short-term outcomes (weeks). And while some studies appeared to show better pain relief with active spinal cord stimulation, the benefits were small, and the evidence was uncertain.

    Only one high-quality study compared spinal cord stimulation to placebo up to six months, and it showed no benefit. The review concluded the data doesn’t support the use of spinal cord stimulation for people with back pain.

    What about the harms?

    The experimental studies often had small numbers of participants, making any estimate of the harms of spinal cord stimulation difficult. So we need to look to other sources.

    A review of adverse events reported to Australia’s Therapeutic Goods Administration found the harms can be serious. Of the 520 events reported between 2012 and 2019, 79% were considered “severe” and 13% were “life threatening”.

    We don’t know exactly how many spinal cord stimulators were implanted during this period, however this surgery is done reasonably widely in Australia, particularly in the private and workers compensation sectors. In 2023, health insurance data showed more than 1,300 spinal cord stimulator procedures were carried out around the country.

    In the review, around half the reported harms were due to a malfunction of the device itself (for example, fracture of the electrical lead, or the lead moved to the wrong spot in the body). The other half involved declines in people’s health such as unexplained increased pain, infection, and tears in the lining around the spinal cord.

    More than 80% of the harms required at least one surgery to correct the problem. The same study reported four out of every ten spinal cord stimulators implanted were being removed.

    A man lying on a bed with a hand on his lower back.
    Chronic back pain can be debilitating. CGN089/Shutterstock

    High costs

    The cost here is considerable, with the devices alone costing tens of thousands of dollars. Adding associated hospital and medical costs, the total cost for a single procedure averages more than $A50,000. With many patients undergoing multiple repeat procedures, it’s not unusual for costs to be measured in hundreds of thousands of dollars.

    Rebates from Medicare, private health funds and other insurance schemes may go towards this total, along with out-of-pocket contributions.

    Insurers are uncertain of the effectiveness of spinal cord stimulators, but because their implantation is listed on the Medicare Benefits Schedule and the devices are approved for reimbursement by the government, insurers are forced to fund their use.

    Industry influence

    If the evidence suggests no sustained benefit over placebo, the harms are significant and the cost is high, why are spinal cord stimulators being used so commonly in Australia? In New Zealand, for example, the devices are rarely used.

    Doctors who implant spinal cord stimulators in Australia are well remunerated and funding arrangements are different in New Zealand. But the main reason behind the lack of use in New Zealand is because pain specialists there are not convinced of their effectiveness.

    In Australia and elsewhere, the use of spinal cord stimulators is heavily promoted by the pain specialists who implant them, and the device manufacturers, often in unison. The tactics used by the spinal cord stimulator device industry to protect profits have been compared to tactics used by the tobacco industry.

    A 2023 paper describes these tactics which include flooding the scientific literature with industry-funded research, undermining unfavourable independent research, and attacking the credibility of those who raise concerns about the devices.

    It’s not all bad news

    Many who suffer from chronic pain may feel disillusioned after watching the Four Corners report. But it’s not all bad news. Australia happens to be home to some of the world’s top back pain researchers who are working on safe, effective therapies.

    New approaches such as sensorimotor retraining, which includes reassurance and encouragement to increase patients’ activity levels, cognitive functional therapy, which targets unhelpful pain-related thinking and behaviour, and old approaches such as exercise, have recently shown benefits in robust clinical research.

    If we were to remove funding for expensive, harmful and ineffective treatments, more funding could be directed towards effective ones.

    Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney; Adrian C Traeger, Research Fellow, Institute for Musculoskeletal Health, University of Sydney, and Caitlin Jones, Postdoctoral Research Associate in Musculoskeletal Health, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Cheeky diet soft drink getting you through the work day? Here’s what that may mean for your health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many people are drinking less sugary soft drink than in the past. This is a great win for public health, given the recognised risks of diets high in sugar-sweetened drinks.

    But over time, intake of diet soft drinks has grown. In fact, it’s so high that these products are now regularly detected in wastewater.

    So what does the research say about how your health is affected in the long term if you drink them often?

    Breakingpic/Pexels

    What makes diet soft drinks sweet?

    The World Health Organization (WHO) advises people “reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (six teaspoons) per day would provide additional health benefits.”

    But most regular soft drinks contain a lot of sugar. A regular 335 millilitre can of original Coca-Cola contains at least seven teaspoons of added sugar.

    Diet soft drinks are designed to taste similar to regular soft drinks but without the sugar. Instead of sugar, diet soft drinks contain artificial or natural sweeteners. The artificial sweeteners include aspartame, saccharin and sucralose. The natural sweeteners include stevia and monk fruit extract, which come from plant sources.

    Many artificial sweeteners are much sweeter than sugar so less is needed to provide the same burst of sweetness.

    Diet soft drinks are marketed as healthier alternatives to regular soft drinks, particularly for people who want to reduce their sugar intake or manage their weight.

    But while surveys of Australian adults and adolescents show most people understand the benefits of reducing their sugar intake, they often aren’t as aware about how diet drinks may affect health more broadly.

    A dark bubbly liquid is poured into a cup filled with ice.
    Diet soft drinks contain artificial or natural sweeteners. Vintage Tone/Shutterstock

    What does the research say about aspartame?

    The artificial sweeteners in soft drinks are considered safe for consumption by food authorities, including in the US and Australia. However, some researchers have raised concern about the long-term risks of consumption.

    People who drink diet soft drinks regularly and often are more likely to develop certain metabolic conditions (such as diabetes and heart disease) than those who don’t drink diet soft drinks.

    The link was found even after accounting for other dietary and lifestyle factors (such as physical activity).

    In 2023, the WHO announced reports had found aspartame – the main sweetener used in diet soft drinks – was “possibly carcinogenic to humans” (carcinogenic means cancer-causing).

    Importantly though, the report noted there is not enough current scientific evidence to be truly confident aspartame may increase the risk of cancer and emphasised it’s safe to consume occasionally.

    Will diet soft drinks help manage weight?

    Despite the word “diet” in the name, diet soft drinks are not strongly linked with weight management.

    In 2022, the WHO conducted a systematic review (where researchers look at all available evidence on a topic) on whether the use of artificial sweeteners is beneficial for weight management.

    Overall, the randomised controlled trials they looked at suggested slightly more weight loss in people who used artificial sweeteners.

    But the observational studies (where no intervention occurs and participants are monitored over time) found people who consume high amounts of artificial sweeteners tended to have an increased risk of higher body mass index and a 76% increased likelihood of having obesity.

    In other words, artificial sweeteners may not directly help manage weight over the long term. This resulted in the WHO advising artificial sweeteners should not be used to manage weight.

    Studies in animals have suggested consuming high levels of artificial sweeteners can signal to the brain it is being starved of fuel, which can lead to more eating. However, the evidence for this happening in humans is still unproven.

    You can’t go wrong with water. hurricanehank/Shutterstock

    What about inflammation and dental issues?

    There is some early evidence artificial sweeteners may irritate the lining of the digestive system, causing inflammation and increasing the likelihood of diarrhoea, constipation, bloating and other symptoms often associated with irritable bowel syndrome. However, this study noted more research is needed.

    High amounts of diet soft drinks have also been linked with liver disease, which is based on inflammation.

    The consumption of diet soft drinks is also associated with dental erosion.

    Many soft drinks contain phosphoric and citric acid, which can damage your tooth enamel and contribute to dental erosion.

    Moderation is key

    As with many aspects of nutrition, moderation is key with diet soft drinks.

    Drinking diet soft drinks occasionally is unlikely to harm your health, but frequent or excessive intake may increase health risks in the longer term.

    Plain water, infused water, sparkling water, herbal teas or milks remain the best options for hydration.

    Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Navigating the health-care system is not easy, but you’re not alone.

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Hello, dear reader!

    This is my first column for Healthy Debate as a Patient Navigator. This column will be devoted to providing patients with information to help them through their journey with the health-care system and answering your questions.

    Here’s a bit about me: I have been a patient partner at The Ottawa Hospital and Ottawa Hospital Research Institute since 2017, and have joined a variety of governance boards that work on patient and caregiver engagement such as the Patient Advisors Network, the Ontario Health East Region Patient and Family Advisory Council and the Equity in Health Systems Lab.

    My journey as a patient partner started much before 2017 though. When I was a teenager, I was diagnosed with a cholesteatoma, a rare and chronic disease that causes the development of fatty tumors in the middle ear. I have had multiple surgeries to try to fix it but will need regular follow-ups to monitor whether the tumor returns. Because of this, I also live with an invisible disability since I have essentially become functionally deaf in one ear and often rely on a hearing aid when I navigate the world.

    Having undergone three surgeries in my adolescent years, it was my experience undergoing surgery for an acute hand and wrist injury following a jet ski accident as an adult that was the catalyst for my decision to become a patient partner. There was an intriguing contrast between how I was cared for at two different health-care institutions, my age being the deciding factor at which hospital I went to (a children’s hospital or an adult one).

    The most memorable example was how, as a teenager or child, you were never left alone before surgery, and nurses and staff took all the time necessary to comfort me and answer my (and my family’s) questions. I also remember how right before putting me to sleep, the whole staff initiated a surgical pause and introduced themselves and explained to me what their role was during my surgery.

    None of that happened as an adult. I was left in a hallway while the operating theater was prepared, anxious and alone with staff walking by not even batting an eye. My questions felt like an annoyance to the care team; as soon as I was wheeled onto the operating room table, the anesthetist quickly put me to sleep. I didn’t even have the time to see who else was there.

    Now don’t get me wrong: I am incredibly appreciative with the quality of care I received, but it was the everyday interactions with the care teams that I felt could be improved. And so, while I was recovering from that surgery, I looked for a way to help other patients and the hospital improve its care. I discovered the hospital’s patient engagement program, applied, and the rest is history!

    Since then, I have worked on a host of patient-centered policy and research projects and fervently advocate that surgical teams adopt a more compassionate approach with patients before and after surgery.

    I’d be happy to talk a bit more about my journey if you ask, but with that out of the way … Welcome to our first patient navigator column about patient engagement.

    Conceptualizing the continuum of Patient Engagement

    In the context of Canadian health care, patient engagement is a multifaceted concept that involves active collaboration between patients, caregivers, health-care providers and researchers. It involves patients and caregivers as active contributors in decision-making processes, health-care services and medical research. Though the concept is not new, the paradigm shift toward patient engagement in Canada started around 2010.

    I like to conceptualize the different levels of patient engagement as a measure of the strength of the relationship between patients and their interlocutors – whether it’s a healthcare provider, administrator or researcher – charted against the duration of the engagement or the scope of input required from the patient.

    Defining different levels of Patient Engagement

    Following the continuum, let’s begin by defining different levels of patient engagement. Bear in mind that these definitions can vary from one organization to another but are useful in generally labelling the level of patient engagement a project has achieved (or wishes to achieve).

    Patient involvement: If the strength of the relationship between patients and their interlocutors is minimal and not time consuming or too onerous, then perhaps it can be categorized as patient involvement. This applies to many instances of transactional engagement.

    Patient advisory/consulting: Right in the middle of our continuum, patients can find themselves engaging in patient advisory or consulting work, where projects are limited in scope and duration or complexity, and the relationship is not as profound as a partnership.

    Patient partnership: The stronger the relationship is between the patient and their interlocutor, and the longer the engagement activity lasts or how much input the patient is providing, the more this situation can be categorized as patient partnership. It is the inverse of patient involvement.

    Examples of the different levels of Patient Engagement

    Let’s pretend you are accompanying a loved one to an appointment to manage a kidney disease, requiring them to undergo dialysis treatment. We’ll use this scenario to exemplify what label could be used to describe the level of engagement.

    Patient involvement: In our case, if your loved one – or you – fills out a satisfaction or feedback survey about your experience in the waiting room and all that needed to be done was to hand it back to the clerk or care team, then, at a basic level, you could likely label this interaction as a form of patient involvement. It can also involve open consultations around a design of a new look and feel for a hospital, or the understandability of a survey or communications product. Interactions with the care team, administrators or researchers are minimal and often transactional.

    Patient advisory/consulting: If your loved one was asked for more detailed information about survey results over the course of a few meetings, this could represent patient advisory/consulting. This could mean that patients meet with program administrators and care providers and share their insights on how things can be improved. It essentially involves patients providing advice to health-care institutions from the perspective of patients, their family members and caregivers.

    Patient advisors or consultants are often appointed by hospitals or academic institutions to offer insights at multiple stages of health-care delivery and research. They can help pilot an initiative based on that feedback or evaluate whether the new solutions are working. Often patient advisors are engaged in smaller-term individual projects and meet with the project team as regularly as required.

    Patient partnership: Going above and beyond patient advisory, if patients have built a trusting relationship with their care team or administrators, they could feel comfortable enough to partner with them and initiate a project of their own. This could be for a project in which they study a different form of treatment to improve patient-centered outcomes (like the time it takes to feel “normal” following a session); it could be working together to identify and remove barriers for other patients that need to access that type of care. These projects are not fulfilled overnight, but require a collaborative, longstanding and trusting relationship between patients and health-care providers, administrators or researchers. It ensures that patients, regardless of severity or chronicity of their illness, can meaningfully contribute their experiences to aid in improving patient care, or develop or implement policies, pilots or research projects from start to finish.

    It is leveraging that lived and living experience to its full extent and having the patient partner involved as an equal voice in the decision-making process for a project – over many months, usually – that the engagement could be labeled a partnership.

    Last words

    The point of this column will be to answer or explore issues or questions related to patient engagement, health communications or even provide some thoughts on how to handle a particular situation.

    I would be happy to collect your questions and feedback at any time, which will help inform future columns. Just email me at max@le-co.ca or connect with me on social media (Linked In, X / Twitter).

    It’s not easy to navigate our health-care systems, but you are not alone.

    This article is republished from healthydebate under a Creative Commons license. Read the original article.

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