BMJ  2007;335:968-970 (10 November), doi:10.1136/bmj.39372.540903.94

Analysis

Support for self care for patients with chronic disease

National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL

Anne Kennedy, Anne Rogers, and Peter Bower argue that effective self care requires fundamental changes in professional attitudes and the way health care is delivered

The first 150 words of the full text of this article appear below.

Effectively managing long term conditions and the burden they place on patients, professionals, and services is a major focus of current health policy. Support for self care is increasingly viewed as a core component of the management of long term conditions.¹ However, despite the enthusiastic promotion of self care, randomised controlled trials often show modest benefits.² We examine why current initiatives fail to deliver and suggest what needs to be done.

Potential benefits of self care

Self care is defined as the actions individuals "take to lead a healthy lifestyle; to meet their social, emotional and psychological needs; to care for their long-term condition; and to prevent further illness or accidents."³ The potential benefits of self care are substantial. According to the proponents of the chronic care model (one of the most comprehensive models of care for long term conditions): "All patients with chronic illness make decisions and engage in behaviours that affect their health . . . [Full text of this article]

Supporting self care in the NHS

Whole systems perspective

Widening the evidence base

Taking the patient perspective into account
Encouraging professionals to change
How do services need to be organised differently?
Summary points

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