TY - JOUR

T1 - Is Europe putting theory into practice?

T2 - A qualitative study of the level of self-management support in chronic care management approaches

AU - Elissen, Arianne

AU - Nolte, Ellen

AU - Knai, Cécile

AU - Brunn, Matthias

AU - Chevreul, Karine

AU - Conklin, Annalijn

AU - Durand-Zaleski, Isabelle

AU - Erler, Antje

AU - Flamm, Maria

AU - Frølich, Anne

AU - Fullerton, Birgit

AU - Jacobsen, Ramune

AU - Saz-Parkinson, Zuleika

AU - Sarria-Santamera, Antonio

AU - Sönnichsen, Andreas

AU - Vrijhoef, Hubertus

PY - 2013/3/26

Y1 - 2013/3/26

N2 - BACKGROUND: Self-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice.METHODS: We conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals' views on the implementation of self-management support in practice.RESULTS: Self-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients' medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture.CONCLUSIONS: Although collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes.

AB - BACKGROUND: Self-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice.METHODS: We conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals' views on the implementation of self-management support in practice.RESULTS: Self-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients' medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture.CONCLUSIONS: Although collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes.

KW - Chronic Disease/therapy

KW - Europe

KW - Humans

KW - Models, Theoretical

KW - Organizational Case Studies

KW - Qualitative Research

KW - Self Care

KW - Social Support

U2 - 10.1186/1472-6963-13-117

DO - 10.1186/1472-6963-13-117

M3 - Journal article

C2 - 23530744

VL - 13

SP - 117

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

ER -