Patients with chronic diseases could benefit if there were better systems in primary care to help them develop their capacity to manage their own conditions.
That is the suggestion from a recent Queensland study investigating some of the barriers to and enablers of self-management support (or SMS) for patients with chronic conditions.
The study is profiled in the latest update from the Primary Health Care Research and Information Service (PHC RIS).
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What might help patients to play a more active role in managing chronic conditions?
Olga Anikeeva writes:
Self-management support (SMS) aims to develop the confidence and skills of chronic disease patients and caregivers that would enable them to take greater responsibility for their own disease management and care.
Specifically, SMS develops patients’ knowledge of their condition, promotes adherence to a treatment plan, encourages shared decision making with health professionals and supports effective monitoring and management of symptoms.
In order to support SMS, health professionals require education and training; however, training alone does not always lead to health professionals utilising SMS with their patients. Currently in Australia there is limited integration of SMS into primary health care.
The aim of this study was to establish whether SMS is being used by health professionals and to identify barriers and enablers for SMS in practice.
Training in SMS principles with a focus on skill building was provided to health professionals in the Townsville General Practice Network through a 2-day workshop. Participants consisted of GPs, practice nurses, allied health professionals, community nurses and health administrators. Post-workshop evaluations and follow-up interviews were used to inform this study.
All workshop participants believed that SMS training was partially or entirely relevant to their own practice and rated their understanding of the principles as moderate or better.
However, 5 out of 14 participants stated that they utilised SMS minimally or not at all in their practice.
The most frequently mentioned barriers to implementation were current funding models for health care, lack of space and lack of staff interest. Conversely, the most frequently reported enabler was increased training for GPs and practice nurses.
Participants also mentioned that support from managers was an important factor, while others expressed concern about the amount of additional time needed to implement SMS strategies. Differences in health professionals’ attitudes towards SMS and their perceived value of this tool were also highlighted.
The authors argue that the inability of primary care settings to provide SMS can have a negative impact on evidence-based practice, limit effective use of the practice team and impede recruitment and retention of primary care practitioners.
They recommend providing SMS training for all GPS and practice nurses, supported by practice management systems that allow adequate time for these interventions.
• Olga Anikeeva is Research Associate, Primary Health Care Research & Information Service (PHC RIS)
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Cheffins TE, Twomey JA, et al. (2012). An evaluation of the self-management support capacity of providers of chronic condition primary care. Australian Journal of Primary Health, 18: 112-115.
This article, which can be accessed at http://www.publish.csiro.au/paper/PY11021.htm, features in the 10 May 2012 edition of PHC RIS eBulletin, available at http://www.phcris.org.au/publications/ebulletin/index.php.
The eBulletin is designed to inform readers of recently published articles and reports, news items, media releases, upcoming conferences and courses, research grants, scholarships and fellowships, PHC RIS products and services and relevant websites in the primary health care field. Those interested in receiving the weekly eBulletin are invited to subscribe to the free service at http://www.phcris.org.au/mailinglists/index.php
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Previous PHC RIS columns at Croakey
• Some useful tips for finding health policy information on the web
• Pros and cons of telehealth for people in rural areas
• What helps GPs provide better mental healthcare (and what doesn’t)
• Improving collaboration in diabetes care
• Improving dementia management in general practice
• Pets and what they do for our health
• Improving the diagnosis of ovarian cancer
• Chronic health problems and depression
• Helping older patients with chronic diseases to navigate the health system
• Tackling overuse of antibiotics
• When doctors prescribe exercise, does it make any difference?
• Caring for country is also good for Aboriginal people
• The perils of surrogate markers
• Are Australians willing to pay more for better oral health?
• What helps encourage self-care for those with chronic illness?
• More effort needed to strengthen shared care for people with serious mental illness
