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Promoting self-management in patients with long term conditions

Little data recorded in study to address shortfalls of self-management in long term condition patients.

Promoting self-management in long term conditions (LTC) is an important part of healthcare. Patient Activation is defined as patients’ understanding, skills and confidence in managing their own health.

Higher levels of patient activation are associated with better self-management.

self-management in patients
Self-managing a long term condition is focus
of new study. Picture: Getty

However there is little data on its extent in primary care patients with LTC. This study addressed this gap through a prospective cohort postal questionnaire study of general practice patients aged over 65 with at least one LTC in Salford. 

The questionnaire had a patient activation measure (PAM) as well as measures of health related quality of life, health literacy, social support and depression. Change was measured by a repeat questionnaire at six months. 

Surveyed adults

Of the 3390 older adults who returned both questionnaires, 15% self-reported PAM level 1 (passive recipients of care), 16% level 2 (lack basic knowledge and confidence to self-manage), 45% level 3 (have basic knowledge but lack confidence and skills), and 25% level 4 (have confidence and knowledge to self-manage but need support at times of crisis).

No factors were identified that predicted change in PAM over six months.

The lowest PAM scores were most prominently associated with depression, in both those with only one LTC and those with multiple LTCs. This may help inform more tailored interventions for improved self-management (such as health coaching) for older adults with LTCs.

Blakemore A, Hann M, Howells K et al (2016) Patient activation in older people with long-term conditions and multimorbidity: correlates and change in a cohort study in the United Kingdom. BMC Health Serv Res. 16, 1, 582.

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