The evidence for self-management programmes

The evidence for self management is still developing and there is a lack of systemic reviews to draw upon. The definition of self management is very broad, so studies often involve very different interventions and populations which make comparative reviews problematic.

The Danish Centre for Health Technology Assessment found that overall, most studies in the field indicate that group based patient education works. However, the level of evidence and results vary between different types of interventions and target groups, and therefore there are inconclusive findings.

The varied quality of research in this area means that further evaluations of group based patient education and self management interventions are needed to build a solid evidence base.

Although self management support and research into what works is still in its infancy, there is a rapidly growing agreement across health departments and in Governments that self management does work, and that those strategies which enable behaviour change are fundamental to improving health outcomes.

Self management interventions are very varied. There is emerging evidence that those interventions that specifically aim to increase patients levels of self efficacy or self activity are more likely to produce positive outcomes in terms of behaviour change and health outcomes.

An example of an evidence- based self management programme is The Chronic Disease Self Management Programme (CDSMP), developed by the Stanford Patient Education Research Central. A review of the programme concludes that there is moderate to strong evidence that the programme improves the patient’s self rated health, health distress, pain, fatigue, disability, cognitive symptom management, physical activity, and self efficacy. One review concluded that the programme might have a potential to have an impact on public health if implemented at large scale.

Researchers have also started to consider the wider benefits of self management support, meaning its social impact on people’s everyday lives.

Early findings from social return on investment (SROI) studies indicate that having access to self care programmes can support individuals to become reengaged with the local community as productive citizens, through meaningful activities. This can take many forms including improved relationships with family and friends, engagement in volunteering, further education, or positive employment related outcomes.

With thanks to ENOPE (Patient Empowerment. Living with Chronic Disease).

“Part of a series of short discussion topics on different aspects of self-management and patient empowerment written by ENOPE members for the 1st European conference on patient empowerment (ENOPE)”