Self-management interventions in primary care practices in France between 2010 and 2022: a descriptive national study

Our objective was to describe the self-management intervention (SMI) programmes carried out in primary care practices (PCPs) in France between 2010 and 2022.

SMIs are included in the recommendations for chronic disease management, but access remains inequal. Primary care has been identified as a favourable setting for their development.

In partnership with the French Ministry of Health Office of Non-Communicable Diseases, we contacted all Regional Health Agencies (n = 18) to collect the following information from the self-management programme forms: year of authorization/declaration, SMI type, administrative structure, self-management and coordination team, and programme content.

At the 13 participating Regional Health Agencies, we identified 4,922 SMI programmes among which 18% (n = 889) were developed in primary care settings and 5.5% (n = 271) in PCPs. Among the 127 forms on SMI programmes at PCPs (2.6%), multi-professional PCPs (57.5%, n = 73) and healthcare centres (25.9%, n = 33) were the most represented. All programmes had a coordinator (mostly general practitioners, 34.7%, n = 24) among whom 69.7% (n = 69) were trained in coordination. The self-management team included a mean of 8.1 (5.5) primary care providers. The main themes were diabetes (34.6%, n = 44), diabetes and cardiovascular diseases (15.6%, n = 20), and cardiovascular disease (10.2%, n = 13). In France, self-management programmes in PCPs are still rare, lack a multimorbidity approach, and are carried out mainly in PCPs with inter-professional collaboration. A qualitative study to identify the barriers and levers to SMI programmes in PCPs may be particularly relevant.