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Patients, providers report disparate views of self-management support for inflammatory arthritis
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Few patients with inflammatory arthritis reported participating in a structured self-management care program, although many physicians reported providing self-management support within routine care, according to findings published in Arthritis Care and Research.
The researchers also found that, when self-management support is included in routine care, it can improve patient knowledge, skills and confidence.
“To address any potential barriers to providing and accessing structured self-management support programs, and provide an avenue for ongoing, sustainable provision recent models are now seeking to embed self-management support within rheumatology clinical teams,” Hayley McBain, PhD, MSc, of the University of London, and colleagues wrote. “What is unknown is the extent to which rheumatology health care professionals are already embedding self-management support into standard care, or the extent to which patients feel they receive embedded self-management support within their rheumatology consultations.”
To determine the levels of support, both given by physicians and received by patients with inflammatory arthritis, for self-management in the United Kingdom, and to analyze the link between self-management support and increased patient knowledge, skills and confidence, the researchers distributed questionnaires to members and associates of the National Rheumatoid Arthritis Society. In all, 117 health care professionals and 886 patients completed the survey.
Health care professionals answered questions about providing self-management support, and also completed the Clinician Support Patient Activation Measure. Patients completed the Patient Activation Measure and answered questions about receiving support from their physicians.
According to the researchers, 15% of patients reported they had attended a structured self-management program, but more than half said they have the skills, confidence and knowledge to self-manage. This belief among patients was associated with receiving self-management support as part of their routine care from physicians. Although 100% of health care professionals who completed the physician survey felt that patients should be actively involved in their own care, as many as 60% were unable to offer structured self-management support. In addition, health care professionals reported engaging in more self-management support during routine care than patients reported receiving, the researchers found.
“Considering the emphasis placed on patient empowerment and the integration of self-management support into the guidelines for managing arthritis, there seems to be some way to go before evidence has been translated into practice,” McBain and colleagues wrote. “When goal setting and self-monitoring were embedded into routine care this was associated with increased patient knowledge, skills and confidence to self-manage. Patients, however, felt that this does not always occur, which raises concerns about the impact that this may have on their experience of care and the health outcomes of patients with arthritis.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.
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