• Peter Bower, Anne Kennedy, David Reeves, Anne Rogers, Tom Blakeman, Carolyn Chew-Graham, Robert Bowen, Martin Eden, Caroline Gardner, Mark Hann, Victoria Lee, Rebecca Morris, Joanne Protheroe, Gerry Richardson, Caroline Sanders, Angela Swallow, and David Thompson.
• Primary Care Research Group, Community Based Medicine, University of Manchester, 5th Floor Williamson Building, Oxford Road, Manchester M13 9PL, UK.
• Implement Sci. 2012 Jan 26; 7: 7.

BackgroundPatients with long-term conditions are increasingly the focus of quality improvement activities in health services to reduce the impact of these conditions on quality of life and to reduce the burden on care utilisation. There is significant interest in the potential for self-management support to improve health and reduce utilisation in these patient populations, but little consensus concerning the optimal model that would best provide such support. We describe the implementation and evaluation of self-management support through an evidence-based 'whole systems' model involving patient support, training for primary care teams, and service re-organisation, all integrated into routine delivery within primary care.MethodsThe evaluation involves a large-scale, multi-site study of the implementation, effectiveness, and cost-effectiveness of this model of self-management support using a cluster randomised controlled trial in patients with three long-term conditions of diabetes, chronic obstructive pulmonary disease (COPD), and irritable bowel syndrome (IBS). The outcome measures include healthcare utilisation and quality of life. We describe the methods of the cluster randomised trial.DiscussionIf the 'whole systems' model proves effective and cost-effective, it will provide decision-makers with a model for the delivery of self-management support for populations with long-term conditions that can be implemented widely to maximise 'reach' across the wider patient population.Trial Registration NumberISRCTN: ISRCTN90940049.

19 keywords...

hide…