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Frameworks for self-management support for chronic disease: a cross-country comparative document analysis
Selena O'Connell1, Vera J C Mc Carthy2, Eileen Savage2
1School of Nursing & Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland. selena.oconnell@ucc.ie.
BMC Health Services Research
|July 27, 2018
Summary
Frameworks to improve self-management support (SMS) for chronic diseases vary in development and implementation plans. Patient involvement and detailed evaluation strategies are often lacking, impacting potential success.
Area of Science:
- Health Policy
- Chronic Disease Management
- Healthcare Systems
Background:
- Frameworks are crucial for enhancing self-management support (SMS) in chronic disease care.
- Understanding the development and implementation of these frameworks is vital for healthcare reform.
- Current knowledge on the processes underpinning SMS framework development and evaluation is limited.
Purpose of the Study:
- To conduct a cross-country comparative document analysis of SMS frameworks for chronic diseases.
- To analyze frameworks from Organisation for Economic Cooperation and Development (OECD) member countries.
- To compare policy context, content, actors, and processes of development, implementation, and evaluation.
Main Methods:
- Systematic grey literature search for SMS frameworks.
- Document analysis using the Health Policy Triangle framework.
- Comparative analysis of eight framework documents from 2008-2017.
Main Results:
- Frameworks varied in scope, with a noted gap in addressing multimorbidity.
- Common strategies included self-management programs and health professional education.
- Inconsistent actor involvement, particularly limited patient participation, and often inadequate implementation and evaluation plans were observed.
Conclusions:
- Differences in framework design, patient involvement, and implementation planning may affect success.
- Further research is needed to understand the impact of framework variations on implementation.
- Identifying critical success factors for SMS policy implementation is essential.
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