J Carryer et al. Providing and receiving self-management support for chronic illness: patients' and health practitioners' assessments. Journal of Primary Health Care, 2010;1:124-129.

Providing care for people with chronic illness is a major issue for health practitioners around the world, especially as population’s age. Encouraging self-management is beneficial in terms of relieving the burden on the health system, and promoting better health and adherence to medication and advice amongst this group. Carryer and associates measured the level of self-management support being provided to and received by people living with chronic illness in a District Health Board (DHB) region. Self-report questionnaires (PACIC) were completed by 341 people living with chronic illness to measure the self-management support they receive from general practitioners and nurses. A modified version of the PACIC was used with 12 GPs and 77 primary health nurses in the same region to assess the provision of self-management support. Patients' assessments suggest that they are receiving intermittent self-management support for their chronic illness. A comparison of ratings of different health practitioners revealed that nurses were reported to be providing support more consistently than GPs. The health practitioners rated themselves as providing self-management support more often than the patients reported receiving it. Many clinicians also suggested that not all forms of support are appropriate for everyone, suggesting the need to tailor support to the individual.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors suggested that chronic illness support needs to be considered within the context of the individual and to be embedded in an ongoing relationship between the person and the provider. Findings highlighted the benefits of a multidisciplinary team approach to self-management support and education in chronic illness care.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE CONSUMER:
The major weakness disclosed by this study is the lack of a systematic approach to teaching self-management skills to patients. Had they been taught these skills in a formal program, they could have avoided the hit-or-miss approach that characterized whether the patients were taught what actions to take and when to perform them.