Self-management capability in patients with long-term conditions is associated with reduced healthcare utilisation across a whole health economy: cross-sectional analysis of electronic health records

Barker, Isaac; Steventon, Adam; Williamson, R. Anthony; Deeny, Sarah R

doi:10.1136/bmjqs-2017-007635

Cited by 82 publications

(83 citation statements)

References 31 publications

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“…In addition, the SRH has an ability to provide relevant information about the cardiovascular risk in addition and irrespective of traditional risk factors [ 31 ]. Patient activation as measured with PAM is related to the treatment adherence, lifestyle factors, health related outcomes and cost [ 11 – 17 ]. PAM has been validated also in Finland [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

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Relationship between patient activation measurement and self-rated health in patients with chronic diseases

et al. 2020

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Background In the aging population, chronic diseases and multimorbidity are common. Therefore, it is important to engage patients in their self-care. The aim of this study was to analyze the relationship between activity in self-care and self-rated health among primary care patients with chronic diseases. Methods The data of the present study were derived from a research project on the Participatory Patient Care Planning in Primary Care (4PHC). A total of 605 patients were recruited in the Siilinjärvi Health Center from those patients who were being monitored due to the treatment of hypertension, ischemic heart disease or diabetes. We evaluated the level of patient’s activity in self-care with the Patient Activation Measurement (PAM). Self-rated health (SRH) was measured with the 5-item Likert scale. An adjusted hypothesis of linearity across categories of PAM and self-rated health was estimated using analysis of covariance (ANCOVA). Results It was found that 76 patients had low activity, 185 had moderate while 336 patients had high activity as measured with PAM. Patients with the highest activity were younger, less depressed, had a lower body mass index and a higher level of physical activity than those with the lower activity. Correspondingly, good SRH was perceived by 29, 45 and 67% of the patients in these three PAM groups adjusted with sex, age, depressive symptoms (BDI) and number of diseases. There was a significant linear trend (adjusted with age, number of diseases and depressive symptoms) between SRH and PAM, p < 0.001. Conclusions Activity in self-care had an independent, linear relationship with the self-rated health. The present findings suggest that Patient Activation Measurement has the potential to categorize the patients according to their perceived health and their needs related to their disease management and self-care. The present results warrant longitudinal studies on the impact of promoting patient activation levels. Trial registration ClinicalTrials.gov Identifier: NCT02992431. Registered 14 December 2016 https://clinicaltrials.gov/ct2/show/NCT02992431

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Section: Discussionmentioning

confidence: 99%

“…There is convincing evidence that patients who are more active in their self-care generally have better health outcomes and a better health-related quality of life [ 11 – 15 ]. In addition, healthcare costs seem to be lower in these individuals [ 11 , 12 , 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between patient activation measurement and self-rated health in patients with chronic diseases

et al. 2020

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“…The importance of enabling and supporting people with chronic conditions from regional communities to effectively self-manage, 12 and the impact good selfmanagement can have on emergency attendance and hospitalisation rates is reinforced in this study. 28…”

Section: Discussionmentioning

confidence: 99%

Consumer experiences of Chronic Obstructive Pulmonary Disease in regional Australia: A mixed methods study and logic model to identify consumer-experience mechanisms to avoid hospital and enhance outcomes

Moran¹,

Chapman²,

Picard³

et al. 2020

Patient Experience Journal

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“…Alongside a reshaping of ambulatory care, self-management support is essential to comprehensive chronic care (Barker, Steventon, Williamson, & Deeny, 2018;Nuno, Coleman, Bengoa, & Sauto, 2012;Wagner, 1998). Its primary aim is to strengthen individuals' skills and confidence in managing their health and adapting to their conditions' physical and psychosocial consequences for improved quality of life (Barlow et al, 2002).…”

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confidence: 99%

Developing a rare disease chronic care model: Management of systemic sclerosis (MANOSS) study protocol

Kocher

Simon

Dwyer

et al. 2019

Journal of Advanced Nursing

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Aim The aim of the management of systemic sclerosis (MANOSS) study described in this protocol is to develop a chronic care model, based on a contextual analysis and stakeholder involvement, for patients living with the rare disease systemic sclerosis (SSc) in Switzerland. Design Applying an implementation science approach, this study starts with an explanatory sequential mixed method study for contextual analysis, followed by broad stakeholder involvement for model development and a Delphi study to reach consensus. Methods First, a quantitative cross‐sectional survey with patients and healthcare professionals (HPs) will be conducted to identify current practice patterns of chronic illness management and technology readiness. Second, qualitative interviews with patients, family members and HPs will be performed to gain a deeper understanding of care needs identified in the quantitative survey. Third, a model of care will be co‐created with input from patients, HPs and other experts. The eHealth enhanced Chronic Care Model will serve as a guiding framework. The new model and corresponding outcome parameters will be refined using a Delphi‐study approach to reach consensus on a testable model of care for persons living with SSc. The protocol has received research ethics committee approval in September 2018 by the Swiss Ethics Committee. Discussion The MANOSS study's participatory approach is essential for contextual fit of the model for patients with SSc in this setting. Subsequent feasibility testing and implementation are planned to evaluate the model's value in relation to health disparities faced by this patient population. Impact Patients living with this rare disease lack access to coordinated, specialized care and self‐management support from qualified HPs. Reengineering of current care, with consideration for technological opportunities, is warranted to meet patients’ and families’ needs.

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Self-management capability in patients with long-term conditions is associated with reduced healthcare utilisation across a whole health economy: cross-sectional analysis of electronic health records

Abstract: Self-management capability is associated with lower healthcare utilisation and less wasteful use across primary and secondary care.

Cited by 82 publications

References 31 publications

Relationship between patient activation measurement and self-rated health in patients with chronic diseases

Relationship between patient activation measurement and self-rated health in patients with chronic diseases

Consumer experiences of Chronic Obstructive Pulmonary Disease in regional Australia: A mixed methods study and logic model to identify consumer-experience mechanisms to avoid hospital and enhance outcomes

Developing a rare disease chronic care model: Management of systemic sclerosis (MANOSS) study protocol

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