Self-management support bibliography

Key findings from the SMS literature review

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The recent literature review identified:

• what works in providing self-management support in primary care settings

• the barriers to effective provision

• how health literacy affects health outcomes for long-term conditions

• how low health literacy can be mediated with self-management support.

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The major findings from recent SMS research are:

• Supporting self-management requires both a significant commitment to change by health services and health professionals as well as service redesign.

• Health providers need to take a whole-of organisation approach to support self-management.

• It is common for health professionals to set the self-management support agenda and to focus on clinical matters; however, this does not lead to long-term improvements for patients.

• Patient self-efficacy (believing one has the power, resources, and skills to make positive changes and improve one’s health) is essential to self-management; however, this often requires health services to help patients gain this perspective, as well as provide the resources to enable self-management.

• The ownership of decisions in managing long-term conditions needs to sit with patients and involve the people the patient chooses to include in the process, for example focusing on life and health goals rather than medical outcomes.

• Peer support is useful as long as peers receive training and support.

• Low health literacy is a barrier to self-management but can be overcome with good self-management support.

• Self-management support programmes struggle to accommodate the challenges facing people with multimorbidity.

• Those patients living with social disadvantage and long-term conditions face more self-management challenges and have much lower health and life expectations.

• Social/emotional/access challenges for patients affect engagement with self-management.