ArticleBMJ public health2026
'I don't think they involve me in any way': Qualitative study of patient centrality in chronic non-communicable disease management in Ghana.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Chronic non-communicable diseases (CNCDs) pose a significant and growing challenge to public health systems worldwide, including Ghana. The complexities of their management underscore the critical importance of patient engagement in navigating CNCD care. Individuals with CNCDs find themselves at the forefront of their own treatment journeys and need to be empowered to make informed decisions and actively participate in their healthcare. The paradigm shift towards patient-centred CNCD care places patients at the heart of their healthcare experiences. We, therefore, explored patient centrality in CNCD care in Ghana. Methods: This phenomenological study involved 82 adults living with CNCDs and 30 healthcare professionals accessing and providing care, respectively, at the Korle-Bu and Komfo Anokye Teaching Hospitals. Data were collected between January and May 2019 using in-depth interview guides exploring experiences and perceptions of empowerment and involvement in CNCD management, guided by an adapted Wagner's Chronic Care Model. Reflexive thematic analysis was employed to analyse the data using ATLAS.ti V.7.5.7. Results: Patient centrality was inadequately practised during routine CNCD management, with predominantly low levels of patient empowerment and involvement reported. Most patients were not informed about their conditions and healthcare professionals were at times reluctant to engage with patients' questions. A few who felt empowered noted education on management options and were invited to choose their preferences. Similarly, patient involvement in management decision-making was limited, with most patients feeling uninvolved in decisions relating to medication and exercise regimens and their changes. A few, however, noted being consulted on changes to medication. Conclusions: Healthcare professionals and patients recognise the importance of the centrality of the patient in CNCD management, but their understanding of how and the extent of patient centrality differs. Patient empowerment through information sharing, education, and participation in care decision-making is key to achieving optimal involvement, and treatment protocols should acknowledge patients as partners to encourage collaborative discussions between patients and healthcare professionals.
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