Characterizing patient-oriented tools that could be packaged with guidelines to promote self-management and guideline adoption: a meta-review

Abstract

BackgroundSelf-management is an important component of care for patients or consumers (henceforth termed patients) with chronic conditions. Research shows that patients view guidelines as potential sources of self-management support. However, few guidelines provide such support. The primary purpose of this study was to characterize effective types of self-management interventions that could be packaged as resources in (i.e., appendices) or with guidelines (i.e., accompanying products).MethodsWe conducted a meta-review of systematic reviews that evaluated self-management interventions. MEDLINE, EMBASE, and the Cochrane Library were searched from 2005 to 2014 for English language systematic reviews. Data were extracted on study characteristics, intervention (content, delivery, duration, personnel, single or multifaceted), and outcomes. Interventions were characterized by the type of component for different domains (inform, activate, collaborate). Summary statistics were used to report the characteristics, frequency, and impact of the types of self-management components. A Measurement Tool to Assess Systematic Reviews (AMSTAR) was used to assess the methodological quality of included reviews.ResultsSeventy-seven studies were included (14 low, 44 moderate, 18 high risk of bias). Reviews addressed numerous clinical topics, most frequently diabetes (23, 30 %). Fifty-four focused on single (38 educational, 16 self-directed) and 21 on multifaceted interventions. Support for collaboration with providers was the least frequently used form of self-management. Most conditions featured multiple types of self-management components. The most frequently occurring type of self-management component across all studies was lifestyle advice (72 %), followed by psychological strategies (69 %), and information about the condition (49 %). In most reviews, the intervention both informed and activated patients (57, 76 %). Among the reviews that achieved positive results, 83 % of interventions involved activation alone, 94 % in combination with information, and 95 % in combination with information and collaboration. No trends in the characteristics and impact of self-management by condition were observed.ConclusionsThis study revealed numerous opportunities for enhancing guidelines with resources for both patients and providers to support self-management. This includes single resources that provide information and/or prompt activation. Further research is needed to more firmly establish the statistical association between the characteristics of self-management support and outcomes; and to and optimize the design of self-management resources that are included in or with guidelines, in particular, resources that prompt collaboration with providers.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-016-0419-1) contains supplementary material, which is available to authorized users.

Factors influencing self‐management behaviours among patients with type 2 diabetes mellitus in the Solomon Islands

“…Furthermore, DSM is a lifetime process involving complex activities that the they must integrate into daily life (Elliott et al, 2013). According to Vernooij, Willson, and Gagliardi (2015), the daily activities that are required as a part of DSM often demand competencies in specific skills, interactive collaboration with HCPs and social support from the family. Therefore, successfully integrating these activities requires persons with diabetes to manage in the context of their real-life goals, priorities, health issues, family demands and personal concerns (Lin, Anderson, Chang, Hagerty, & Loveland-Cherry, 2008).…”

Examining the context and helpfulness of family companion contributions to older adults’ primary care visits

“…[18, 19] A recent nationally representative study found that older adults’ decision-making preferences varied widely with respect to whether they managed their health independently or with the involvement of family. [5] Other studies find that patients commonly engage in treatment planning with family but that the nature and degree of family involvement is highly variable[7, 9, 12] with low congruence in patient and family expectations regarding the role of family and patient preferences for communication assistance from family.…”

Knowledge translation strategies for dissemination with a focus on healthcare recipients: an overview of systematic reviews

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