23 Mar Is Self-management of Chronic Diseases & Multimorbidity effective?
Self-management education teaches problem-solving skills and results in enhanced self-efficacy as well as facilitating optimum quality of life (QOL) for patients with chronic diseases. For the majority, self-management, in which patients make day-to-day decisions about managing their own illnesses, shows significant benefits when there is increased support from healthcare professionals. However it is important that these healthcare professionals receive specific education to equip them to effectively educate patients on self-management.
Looking back to our last blog we looked at the crucial role Primary Care has in managing Multimorbidity, Practice Nurses are an important part of the primary care team and studies have shown that Practice Nurses are effective at providing self-management support .
Evidence suggests that:
- clinical outcomes are improved when chronic disease management programs teaching self-management skills are incorporated rather than information-only patient education
- self-management education improves outcomes and reduces costs for arthritis and probably for adult asthma patients
- self-management education programmes bringing together patients with a variety of chronic diseases may improve outcomes and reduce costs.
- a systematic review by Dennis found that self-management interventions are effective in improving both process of care and patient outcomes
However there are some barriers to self-management; for instance Bayliss found that a higher level of morbidity, greater financial constraints, greater number of confounding effects of conditions, persistent depressive symptoms, higher level of patient-clinician communication and lower income were all barriers to self-care.
Most of the evidence for self-management support is based on patients with diabetes and hypertension, there is some for arthritis and less clear evidence for asthma and COPD.
So self -management should be seen as an integral part of quality primary healthcare. However the process of self-management for patients with multimorbidities is complex as they must integrate self-management for coexisting and often interacting diseases.