Nurses in Asia Pacific are going beyond traditional roles to drive better outcomes through nurse-led Patient Support Programmes (PSPs). Their impact on chronic care and continuity is quietly reshaping healthcare from the ground up.
Healthcare systems all over Asia Pacific have long grappled with the rising burden of chronic diseases and ageing populations. While discussions around transformative healthcare have largely focused on policy shifts or new technology, a quieter yet equally remarkable force is reshaping the patient experience: nurses.
Nurses are at the heart of how patients undergo and engage with care. Through nurse-led Patient Support Programmes (PSPs), they are also being empowered to go beyond conventional duties to bridge critical gaps in care, ultimately changing the trajectory of patient health outcomes.
To get a deeper understanding of this, we spoke with two nurses leading PSPs in different contexts: Jeanne Foo, based in Singapore, and Atikarn Boonthanathitapha, based in Thailand.
Jeanne Foo: Enhancing Care on Home Ground
– Jeanne Foo, 35, Nurse Educator
Having been a registered nurse for over 10 years, Jeanne’s background runs across general medicine, obstetrics & gynaecology, and fertility. This gave her a broader perspective in patient care, even as she acknowledges that the dynamics inherent in each specialty are unique.
“What ties these specialties together is the need for both technical expertise and emotional intelligence. As a nurse, I adapt my communication style, education methods, and support strategies to meet patients where they are, both medically and emotionally,” she said.
This wealth of insight drew her to taking a lead role within PSPs in diverse areas, from dermatology and paediatrics to immunology.
“Over the years, I’ve had the opportunity to lead teams, manage complex clinical operations, and even collaborate with health tech developers to optimise clinic systems. These experiences taught me that patient care goes beyond clinical treatment – it’s also about building structures that support patients holistically and sustainably.”
Her Role: Collaboration and Coordination
“My approach is to act as a central coordinator and communicator,” highlighted Jeanne.
“With doctors, I make sure I understand their treatment goals and update them regularly with patient progress and any issues that arise. With caregivers and families, I position myself as a reliable point of contact, someone they can turn to for clarification or reassurance.”
To bolster all aspects of the PSP, she works closely with stakeholders like cross-functional teams, pharma clients, operations managers, and compliance officers. She also maintains detailed records of patient interactions and feedback for a more informed and comprehensive view of the programme.
It’s this triangulation that ensures greater alignment, thus reducing gaps and establishing trust.
But her responsibilities don’t end at stakeholder engagement and patient support. She also doubles as an advocate and systems thinker, training healthcare professionals and contributing to programme design.
“This shows how nursing in PSPs isn’t confined to direct care. It involves leadership, education, and cross-functional collaboration, all aimed at enhancing patient outcomes and programme effectiveness.”
Compliance and Care: A Balancing Act
While Jeanne gives a lot of attention to establishing patient-centred care, she stresses the importance of compliance in keeping programmes credible and patients safe.
“I do this by ensuring transparency, so patients understand why protocols exist, whether it’s regular monitoring, data collection, or follow-up calls. When they see these measures as part of their safety net rather than just ‘red tape,’ they are more engaged,” she explained.
She also practices flexibility wherever she can within the fixed structures provided under compliance, depending on patient needs and preferences.
Importantly, she provides upward feedback when it’s called for.
“If compliance requirements are creating barriers to patient engagement, I escalate those concerns and work with programme managers to refine approaches. This way, compliance becomes part of a supportive framework rather than a burden.”
Small Steps, Big Impact
For Jeanne, the core of her work is about creating an ongoing dialogue with patients, ensuring they understand their treatment, feel empowered, and know they have someone they can trust.
“One case that stands out is a young patient undergoing immunology treatment who was struggling with adherence due to side effects and frustration with the slow progress.
“Through the programme, I scheduled regular check-ins, provided education on what to expect at each stage, and helped set realistic timelines for improvement.”
Most notable was how she proved herself as an emotional anchor, listening to and validating her patient’s concerns, and providing coping strategies. Jeanne also engaged with her caregivers to better equip them to supporting her at home. While some of these actions may even seem trivial, they accumulated over time to result in sustained treatment, and meaningful clinical improvements.
“She later told me that having someone who understood both the medical and emotional aspects of her journey was what kept her going,” recounted Jeanne.
“This encapsulates the true value of PSPs, helping patients stay the course by addressing the whole experience, not just the prescription.”
Atikarn Boonthanathitapha: Advancing Care Beyond the Hospital
– Atikarn Boonthanathitapha, 30, Registered Nurse, PAP and PSP Specialist, Client Management
Atikarn started out her nursing career specialising in neurology and respiratory care – and witnessed a critical issue when it came to long-term treatment.
“Over time, I noticed that many patients struggled to manage their care once discharged, particularly elderly patients and those with chronic conditions,” she imparted.
It was her observations that pulled her out of the hospital and into home-based education and patient support.
“Transitioning into home-based education felt like a natural extension of my work,” she revealed. “I realised that patient support doesn’t end at the hospital door. It continues in daily life, in the patient’s home, and with their families.”
Her Goal: Building Confidence and Trust
When it comes to helping patients who are elderly or those with chronic conditions, Atikarn’s first step is simplification.
“Simplification begins with understanding each patient’s routine and limitations. I often use visual tools such as pill organisers, colour-coded systems, and simple charts that align medication schedules with daily activities.
“For more complex regimens, I collaborate with physicians to explore options like combination medications or adjusted timings to reduce the number of daily doses.”
Importantly, Atikarn would describe the value and necessity behind each prescription.
“When families understand that a blood pressure pill helps prevent strokes, they are more motivated to ensure consistency.”
Furthermore, she takes the time to understand her patients, looking beyond medical needs to delve into their true concerns.
“Many elderly patients are anxious about becoming a burden or losing independence. I acknowledge these feelings while showing them practical steps to maintain control over their health.”
And the key underlying all of this is patience and consistency.
“I answer repeated questions with the same care and avoid judgment, no matter how many times information needs to be explained. I also involve family members as active partners in care, which helps create a stronger support network.
“[And] if I promise to call, I call. If I say I’ll bring materials, I deliver. These small, reliable actions demonstrate to patients that they are not forgotten, building the reassurance they need to stay engaged.”
Challenges: Cultural Complexity and Resource Constraint
While helping patients in the comfort of their own living space can be beneficial, adapting outside the hospital setting requires greater effort and cultural sensitivity.
This is underscored by the fact that home environments can be quite varied, with some patients living with family, while others live on their own, and each situation necessitates different levels of support.
“Coordination is another challenge as patients often see multiple specialists, and without a hospital structure, ensuring everyone is aligned takes extra communication,” Atikarn added.
Moreover, these difficulties are set against the healthcare structure of Thailand, where underserved communities remain an enduring issue.
“In rural and decentralised areas, patients often face limited access to specialists and must travel long distances for appointments, which may only happen once or twice a year. This leaves large gaps in ongoing support, especially for chronic conditions.”
And in a country with four main dialects, language can also become a barrier.
“Many older patients are more comfortable in local dialects than in central Thai. Combined with low health literacy, this can make understanding treatment even more challenging.”
Filling In the Cracks
In this case, nurses play a critical role in paving the path to better patient outcomes.
“By offering education in local languages, making regular home visits, and collaborating with community health workers, we can bring care closer to patients,” Atikarn explained. “Technology, such as telemedicine, also helps maintain connections between clinic visits. Additionally, by training family caregivers and local volunteers, nurses can build sustainable support systems that extend beyond professional healthcare teams.”
And the outcome is worth any effort.
“I once worked with an elderly man with COPD who was frequently hospitalised because he struggled to use his inhalers correctly and panicked during breathing difficulties. His daughter, who was his main caregiver, was overwhelmed balancing his care with her full-time job,” Atikarn recalled.
“Through several home visits, I not only taught him proper inhaler techniques but also created a personalised action plan for flare-ups. I showed his daughter how to guide him through breathing exercises and how to recognise when to manage at home versus when to seek immediate help.”
Six months later, he had not made another appearance at the hospital.
“His daughter told me he felt confident managing his condition, was even going for short walks again, and, most importantly, they both felt peace of mind knowing they had a clear plan.
“This experience reminded me how education and ongoing support can transform both medical outcomes and family life.”
Responding to the Evolving Healthcare Landscape
Together, Jeanne and Atikarn’s stories reveal how nurses are redefining the boundaries of their profession through PSPs – and why empowering them is essential to the future of healthcare.
“PSPs highlight the value of continuity and proactive care. Instead of waiting for problems to escalate, PSPs provide structured support that keeps patients engaged and adherent, which ultimately reduces complications and hospital visits,” emphasised Jeanne.
As she asserts, the takeaway is less about clinical metrics from isolated appointments, and more about persistence and quality of live, thus reducing the burden on the healthcare system.
Atikarn echoed this sentiment, stating: “Healthcare systems need to formally recognise that nursing roles have evolved. This means creating clear career pathways for nurses specialising in patient education and community care, along with appropriate compensation and recognition.”
This can also involve investing in training programmes that transfer skills in care coordination, social competency, and health education; providing access to tools that would allow nurses to deliver more effective care beyond a hospital; and properly integrating nurses into care planning and policy discussions.
In a final remark, Jeanne noted: “Healthcare organisations in Singapore have started to see nurses as partners in strategy and policy, not just implementers.
“As nursing has now evolved to be part of decision-making at the systems level, we are starting to see more care models that are truly patient-centred and sustainable.”
