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BMC Health Services Research
Published in: BMC Health Services Research 1/2013

Open Access 01-12-2013 | Research article

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

Authors: Arianne Elissen, Ellen Nolte, Cécile Knai, Matthias Brunn, Karine Chevreul, Annalijn Conklin, Isabelle Durand-Zaleski, Antje Erler, Maria Flamm, Anne Frølich, Birgit Fullerton, Ramune Jacobsen, Zuleika Saz-Parkinson, Antonio Sarria-Santamera, Andreas Sönnichsen, Hubertus Vrijhoef

Published in: BMC Health Services Research | Issue 1/2013

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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.
Appendix
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Metadata
Title
Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches
Authors
Arianne Elissen
Ellen Nolte
Cécile Knai
Matthias Brunn
Karine Chevreul
Annalijn Conklin
Isabelle Durand-Zaleski
Antje Erler
Maria Flamm
Anne Frølich
Birgit Fullerton
Ramune Jacobsen
Zuleika Saz-Parkinson
Antonio Sarria-Santamera
Andreas Sönnichsen
Hubertus Vrijhoef
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2013
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-13-117

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