Self-managed care improves perceived health among the 60+

A study led by Flinders University and Deakin University has shown that older Australians living with multiple chronic diseases perceive their health to be better after receiving chronic disease self-management support (CDSMS).

The full results have been published in the Medical Journal of Australia today.

CDSMS programs have been widely implemented in Australia and overseas, but until now the evidence for their effectiveness has been both limited and mixed.

Such programs involve regular health assessments from a clinician who acts as a ‘coach’ and are underpinned by collaborative goal-setting, individualised care plans and problem-solving support.

The objective of CDSMS programs is to increase patients’ skills and confidence in managing their chronic diseases with a view to enhancing their coping ability and avoiding unplanned hopsitalisations.

The research team recruited general practice patients aged 60 years or more with at least two chronic conditions.

Study participants were divided into two groups: one that received CDSMS and one that did not.

Patients in the non-CDSMS group received health information and supportive listening from a health professional only.

“Our study showed that those patients who received CDSMS were more likely than those patients who did not receive CDSMS to report improved self-rated health,” says Professor Richard Reed from Flinders University, who led the study.

“Unexpectedly, improvements in self-rated health did not appear to correlate with measurable improvements to specific aspects of health such as pain, depression and fatigue.

“This may have been because the follow-up period was only six months and it may take longer than this for the true health benefits of CDSMS to become apparent.

“In addition it may be that CDSMS programs need to be refined further to include care coordination and enhanced integration with general practice,” Professor Reed says.

Members of the research team are now conducting a clinical trial to test whether improvements to general practice services can enhance patient health outcomes.

As part of this new trial, high-risk patients with chronic illnesses will be provided with access to extended appointments with a doctor and will be followed-up by their general practice after a significant health event such a hospitalisation.

The full details of the CDSMS research study can be found in the published paper: Reed RL, Roeger L, Howard S et al, A self-management support program for older Australians with multiple chronic conditions: a randomised controlled trial, Medical Journal of Australia, 22 January 2018, vol. 208, no. 2, doi: 10.5694/mja17.00127.


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