Helping patients manage their chronic conditions
- Contributor(s):
- Bodenheimer, Thomas. MacGregor, Kate. Sharifi, Claire. California HealthCare Foundation
- Publication:
- Oakland, Calif. : California HealthCare Foundation, c2005
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Chronic Disease -- therapy Decision Making Health Behavior Self Care -- methods Cooperative Behavior Information Services Motivation Patient Education as Topic Patient-Centered Care Primary Health Care Professional-Patient Relations Humans United States
- Genre(s):
- Technical Report
- Abstract:
- Self-management support is the assistance caregivers give patients with chronic disease in order to encourage daily decisions that improve health-related behaviors and clinical outcomes. Self-management support can be viewed in two ways: as a portfolio of techniques and tools that help patients choose healthy behaviors; and a fundamental transformation of the patient-caregiver relationship into a collaborative partnership. The purpose of self-management support is to aid and inspire patients to become informed about their conditions and take an active role in their treatment. True self-management support involves both patient education and collaborative decision making. This document describes five interlocking strategies that help caregivers work within the collaborative model. The five strategies are: (1) Collaborative decision making: establishing an agenda; (2) Information giving: ask, tell, ask; (3) Information giving: closing the loop; (4) Collaborative decision making: assessing readiness to change; and (5) Collaborative decision making: goal setting. In addition, this document reviews literature describing the effectiveness of self-management support interventions. Among the conclusion from that review: (1) Self-management support does improve health-related behaviors, and as a result, clinical outcomes. (2) The self-management support intervention for which the evidence is strongest is a collaborative interaction between caregiver and patient. (3) Providing information is a necessary--but not sufficient--intervention to improve health-related behaviors or clinical outcomes. (4) A collaborative relationship between caregiver and patient must be added to information giving in order to improve behaviors and outcomes. Providing self-management support presents a major challenge to primary care practices because self-management support takes time--perhaps the most limited resource in primary care. Physicians cannot provide adequate self-management support amid the many competing agendas of a 15-minute office visit. Thus, primary care practices must create teams in which non-physician caregivers are trained to work with physicians in offering self-management support, from information giving and collaborative decision making to assessing patients' readiness to change health-related behaviors and setting behavior-changed goals.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 25 leaves.
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101309864 (See catalog record)
- ISBN:
- 1932064842
- Permanent Link:
- http://resource.nlm.nih.gov/101309864