- To boost self-management for chronically ill patients, providers simply need to provide support, says one study recently published in the American Journal of Managed Care.
Researcher Peter Cunningham, PhD, sought to determine how chronically ill patients perceive support for self-management, and what factors contribute to successful self-care for patients with long-term conditions.
Specifically, Cunningham set out to examine two factors, including the way in which patient engagement and other factors influenced patient perceptions of chronic disease management support, and whether adequate support led to improved patient behaviors.
For the purposes of the study, Cunningham defined patient engagement and self-management – or patient activation – differently, highlighting a difference in how patients engage at the point of care and how they adopt healthy behaviors outside of the doctor’s office.
“Patient engagement is defined as ‘actions individuals must take to obtain the greatest benefit from the healthcare services available to them,’” Cunningham explained. “Patient engagement differs from patient activation—which refers to the ‘skills and confidence that equip patients to become more engaged in their healthcare’—because patient engagement relates more directly to actions that patients take during, or in preparation for, the medical encounter.”
When studying a group of current and retired autoworkers and their spouses, Cunningham hypothesized that higher patient engagement would lead to more perceptions of self-management support from their physicians.
“The study hypothesizes that patients at higher levels of engagement are more likely to perceive receiving self-management support from physicians, both because physicians are likely to be more responsive to patients who demonstrate a high level of interest in their healthcare, and because highly engaged patients are more likely to directly request such support.”
The results showed that self-management support was more nuanced. Although all chronically ill patients reported at least some level of self-management support from their physicians, those with higher patient engagement perceived higher levels of self-management support.
Ultimately, self-management support proved most effective in spurring actual patient self-management. While patient engagement remained an important aspect of care, providers specifically supporting self-management behaviors were most effective in improving patient care.
“The results from this study suggest that while engaged patients report much more self-management support from their clinicians, the association with self-management behaviors is likely more indirect, and self-management support is more directly associated with influencing actual self-management behaviors,” Cunningham noted.
Additionally, high patient engagement levels did not necessarily lead to actual self-management practices, showing that regardless of a patient’s level of engagement, providers should still provide self-management support to inspire healthier behaviors.
“Although patient engagement may influence whether self-management support is given, the results suggest that self-management support may be just as effective with patients who are less engaged with their healthcare,” Cunningham said.
Going forward, providers can adopt self-management support approaches through various different avenues, including individual physician practices, traditional disease management programs, patient-centered medical homes, and ambulatory intensive care units. That said, there is still work to be done to develop best practices that will benefit the most amount of patients.
“In the long run, the effectiveness of such programs will depend not just on whether individual models or practices can achieve results, but whether they can achieve enough critical mass to benefit most patients with chronic conditions,” Cunningham concluded.