The Value of Incremental Care

Incremental care is the adoption of multiple clinical strategies that may increase the effectiveness of a specific treatment. It has more to do with how and by whom therapies are administered than with what is administered. Incremental care is often subsumed under the undifferentiated rubric of placebo, yet its planning and performance require a number of specific steps. Clinical assessment of individual health attitudes and behaviour may disclose particular treatment needs. The capacity of the clinician to address illness behaviour, his/her communication style and clinical skills and the amount of time devoted to the patient are crucial determinants of treatment outcome. The involvement of the patient in his/her own care, which is not restricted to treatment adherence, is an additional key element. The term 'self-therapy' indicates the sum of patient's activities that may counteract the progression of a disease and potentially lead to an optimal state of health. Such activities are best accomplished with the guidance, encouragement and monitoring of a health professional. It is only clinical judgment that allows the clinician to formulate an individualized treatment plan that includes incremental care. Addressing patients' needs by using incremental care is as important as administering appropriate treatments.