Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches

A.M.J. Elissen, E. Nolte, C. Knai, M. Brunn, K. Chevreul, A. Conklin, I. Durand-Zaleski, A. Erler, M. Flamm, A. Frølich, B. Fullerton, R. Jacobsen, Z. Saz-Parkinson, A. Sarria-Santamera, A. Sönnichsen, H.J.M. Vrijhoef

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Abstract

Background
Self-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice.
Methods
We conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals’ views on the implementation of self-management support in practice.
Results
Self-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients’ medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture.
Conclusions
Although collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes.
Keywords: Chronic illness, Disease management, Self-management support, Comparative study, Qualitative research
Original languageEnglish
Article number117
JournalBMC Health Services Research
Volume13
DOIs
Publication statusPublished - 2013

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Disease Management
Health Personnel
Nurses
Delivery of Health Care

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Elissen, A.M.J. ; Nolte, E. ; Knai, C. ; Brunn, M. ; Chevreul, K. ; Conklin, A. ; Durand-Zaleski, I. ; Erler, A. ; Flamm, M. ; Frølich, A. ; Fullerton, B. ; Jacobsen, R. ; Saz-Parkinson, Z. ; Sarria-Santamera, A. ; Sönnichsen, A. ; Vrijhoef, H.J.M. / Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches. In: BMC Health Services Research. 2013 ; Vol. 13.
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title = "Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches",
abstract = "BackgroundSelf-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice.MethodsWe conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals’ views on the implementation of self-management support in practice.ResultsSelf-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients’ medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture.ConclusionsAlthough collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes.Keywords: Chronic illness, Disease management, Self-management support, Comparative study, Qualitative research",
author = "A.M.J. Elissen and E. Nolte and C. Knai and M. Brunn and K. Chevreul and A. Conklin and I. Durand-Zaleski and A. Erler and M. Flamm and A. Fr{\o}lich and B. Fullerton and R. Jacobsen and Z. Saz-Parkinson and A. Sarria-Santamera and A. S{\"o}nnichsen and H.J.M. Vrijhoef",
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year = "2013",
doi = "10.1186/1472-6963-13-117",
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Elissen, AMJ, Nolte, E, Knai, C, Brunn, M, Chevreul, K, Conklin, A, Durand-Zaleski, I, Erler, A, Flamm, M, Frølich, A, Fullerton, B, Jacobsen, R, Saz-Parkinson, Z, Sarria-Santamera, A, Sönnichsen, A & Vrijhoef, HJM 2013, 'Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches', BMC Health Services Research, vol. 13, 117. https://doi.org/10.1186/1472-6963-13-117

Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches. / Elissen, A.M.J.; Nolte, E.; Knai, C.; Brunn, M.; Chevreul, K.; Conklin, A.; Durand-Zaleski, I.; Erler, A.; Flamm, M.; Frølich, A.; Fullerton, B.; Jacobsen, R.; Saz-Parkinson, Z.; Sarria-Santamera, A.; Sönnichsen, A.; Vrijhoef, H.J.M.

In: BMC Health Services Research, Vol. 13, 117, 2013.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches

AU - Elissen, A.M.J.

AU - Nolte, E.

AU - Knai, C.

AU - Brunn, M.

AU - Chevreul, K.

AU - Conklin, A.

AU - Durand-Zaleski, I.

AU - Erler, A.

AU - Flamm, M.

AU - Frølich, A.

AU - Fullerton, B.

AU - Jacobsen, R.

AU - Saz-Parkinson, Z.

AU - Sarria-Santamera, A.

AU - Sönnichsen, A.

AU - Vrijhoef, H.J.M.

N1 - >2000 woorden

PY - 2013

Y1 - 2013

N2 - BackgroundSelf-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice.MethodsWe conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals’ views on the implementation of self-management support in practice.ResultsSelf-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients’ medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture.ConclusionsAlthough collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes.Keywords: Chronic illness, Disease management, Self-management support, Comparative study, Qualitative research

AB - BackgroundSelf-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice.MethodsWe conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals’ views on the implementation of self-management support in practice.ResultsSelf-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients’ medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture.ConclusionsAlthough collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes.Keywords: Chronic illness, Disease management, Self-management support, Comparative study, Qualitative research

U2 - 10.1186/1472-6963-13-117

DO - 10.1186/1472-6963-13-117

M3 - Article

VL - 13

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

M1 - 117

ER -