145,191 members

Skip to content. | Skip to navigation

3: Systematisation of Self care and Self management

Commission peer support groups for people with multiple long term conditions and their carers and provide relevant, accessible information via information prescriptions, patient access to health records and shared decision making tools. Support people with multiple long term conditions and their unpaid carers to be involved in person centred care planning and reablement. Empower people living with multiple long term conditions, their carers and the Voluntary Sector to be full partners in planning, improving quality and enhancing the experience of care via health coaching of professionals and individuals. There is good evidence to suggest that better understanding of a long term condition can improve people’s understanding of their symptoms and enhance long term health and wellbeing. The role of the care professional is to support people by promoting self confidence and self care, help them feel more in control of their lives, support problem solving, and to direct people towards the type of support and information they need. This means listening to their goals and having a more outcome focused approach to planning and reviewing their care plan.

EVIDENCE BASE:

Source: (1) Implementing shared decision making in the UK, Coulter (2009), Health Foundation

O'Connor AM, Llewellyn-Thomas HA, Flood AB. Modifying unwarranted variations in health care: shared decision making using patient decision aids. Health Aff (Millwood). 2004;Suppl Web Exclusives:VAR63-72.

O'Connor AM, Rostom A, Fiset V, Tetroe J, Entwistle V, Llewellyn-Thomas H, Holmes-Rovner M, Barry M, Jones J. Decision aids for patients facing health treatment or screening decisions: systematic review. BMJ. 1999;319(7212):731-4.

Whelan T, Levine M, Willan A, Gafni A, Sanders K, Mirsky D, Chambers S, O'Brien MA, Reid S, Dubois S. Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: a random-ized trial. JAMA. 2004;292(4):435-41.

Morgan MW, Deber RB, Llewellyn-Thomas HA, Gladstone P, Cusimano RJ, O'Rourke K, Tomlinson G, Detsky AS. Randomized, controlled trial of an interactive videodisc decision aid for patients with ischemic heart disease. J Gen Intern Med. 2000;15(10):685-93.

Systematic review of the effects of SDM on patient satisfaction, treatment adherance and Health status, April 2008, Psychotherapy and Psychosomatics

Coulter & Jenkinson “European patients‟ views on the responsiveness of health systems and healthcare providers” (2005) European Journal of Public Health, Vol. 15, No. 4, 355–360

A.Coulter in Shared Decision-Making in Health Care, Adrian Edwards and Glyn Elwyn,2009, p159-160

Involving patients in decision making and communicating risk: a longitudinal evaluation of doctor‟s atti-tudes and confidence during a randomised trial, March 2004, Journal of Evaluation in Clinical Practice

Hibbard et al “Measuring clinician beliefs about patient self-management” (2010)

DH analysis of “Self care survey”, Department of Health/Ipsos-MORI, 2009

Carol Remmers.The Relationship Between the Patient Activation Measure, Future Health Outcomes, and Health Care Utilization Among Patients with Diabetes.Kaiser Care Management Institute,PhD Dissertation.

The impact of patient participation on adherence and clinical outcome in primary care of depression. Loh et al. Patient education and counselling 65(2007) 69-78

GP patient survey, Department of Health/Ipsos-MORI 2009-10,

How patients use access to their electronic GP record – a quantative study, Vanita Bhavnania, et al. Fam-ily Practice, Nov 2010

Kennedy et al. “The effectiveness and cost effectiveness of a national lay-led self care support programme for patients with LTCs:a pragmatic RCT” J.Epidemiol.Community Health 2007;61;254-261

A. Shearer et al Cost-effectiveness of flexible intensive insulin management to enable dietary freedom in people with Type 1 diabetes in the UK; Diabetic Medicine, 21, 460–467

Ipsos-MORI, primary care survey 2010

Woolacott N, Orton L, Beynon S, Myers L, Forbes C Systematic review of the clinical effectiveness of self care support networks in health and social care. Health Technology Assessment database http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=32006001556

Research evidence on the effectiveness of self care support, Department of Health (2007

Kinmonth et al. 1998. “Randomised controlled trial of patient centred care of diabetes in general practice: impact on current wellbeing and future disease risk”, BMJ Vol 317 pp1202-1208

Martin et al. 2004. “Care plans for acutely deteriorating COPD: A randomized controlled trial”, Chronic Respiratory Disease Vol 1 pp191-195

Lahdensuo et al. 1996. “Randomised comparison of guided self management and traditional treatment of asthma over one year”, BMJ Vol 312 pp748-752

Ouwens et al. “Integrated care programmes for chronically ill patients: a review of systematic reviews” In J for Quality in Health Care 2005; Volume 17, Number 2: pp. 141–146

Liu et al. 2003. “Cost-effectiveness of collaborative care for depression in a primary care veteran popula-tion”, Psychiatric Services Vol 54 698-704

Katon et al. 1999. “Stepped collaborative care for primary care patients with persistent symptoms of de-pression”, Archives of General Psychiatry Vol 56 pp1109-1115

Olivarius et al. 2001. “Randomised controlled trial of structured personal care of type 2 diabetes mellitus”, BMJ Vol 323(7319) p970

Care planning impact assessment, Department of Health, Jan 2009

Charmel P, Frampton S. Building the Business Case for Patient Centered Care. HFM. March, 2008

Fremont, Cleary et al J. Gen. Intern. Med 2001:16:800-808