[Supporting patients in self-management: moving to a personalised approach]

Area of Science:

• Health Services Research
• Chronic Disease Management
• Patient Empowerment

Background:

• Effective self-management support is crucial for patients with chronic conditions.
• Patient activation, encompassing knowledge, skills, and self-efficacy, is key to successful self-management.
• Identifying barriers to self-management is essential for tailoring support.

Purpose of the Study:

• To evaluate the impact of personalized self-management support on patient activation and self-management behaviors.
• To assess the effectiveness of the Self-Management Screening (SeMaS) questionnaire in guiding personalized support.
• To determine changes in lifestyle, self-monitoring, and healthcare utilization.

Main Methods:

• A cluster randomized trial involving 15 general practices.
• Patients with chronic conditions received either standard care or personalized support using the SeMaS tool.
• Patient activation (PAM-13) and lifestyle were assessed at baseline and 6 months.
• Data on care plans, referrals, self-monitoring, and healthcare use were collected and analyzed using multilevel regression.

Main Results:

• No significant difference in patient activation was observed between the intervention and control groups after 6 months.
• The intervention group showed a significant increase in self-monitoring behaviors (29.4% vs. 15.2%).
• Per-protocol analysis indicated higher rates of individual care plans and self-monitoring in the intervention group.

Conclusions:

• Personalized self-management support, particularly using the SeMaS method, effectively promotes self-monitoring and the use of individual care plans.
• The intervention did not demonstrate a significant effect on overall patient activation or lifestyle.
• Further research into the potential of the SeMaS tool for enhancing specific self-management behaviors is warranted.