The Medical journal of Australia
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Although emphasis on the prevention of chronic disease is important, governments in Australia need to balance this with continued assistance to the 77% of Australians reported to have at least one long-term medical condition. Self-management support is provided by health care and community services to enhance patients' ability to care for their chronic conditions in a cooperative framework. ⋯ If self-management support is to work, there is a need to better understand the infrastructure, systems and training that are required to engage the key stakeholders - patients, carers, health professionals, and health care organisations. A coordinated approach is required in implementing these elements within existing and new health service models to enhance uptake and sustainability.
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Randomized Controlled Trial
The United Kingdom Expert Patients Programme: results and implications from a national evaluation.
The Expert Patients Programme (EPP) is a central element of chronic disease management policy in the United Kingdom. It aims to deliver self-care support by developing peoples' self-care skills, confidence and motivation to take more effective control over their long-term conditions. ⋯ The development and evaluation of self-care support initiatives should take into account the extent to which self-care support initiatives can be integrated into peoples' everyday lives, and the degree of fit with patients' existing adaptations and strategies. Rather than being concentrated on a single course, central resources for self-management support should be directed at a variety of systems and interventions that are able to meet the wide range of needs of patients with chronic conditions.
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We examined research and implementation activities presented at the Centre for Rheumatic Diseases 2007 Conference and other selected literature to identify common themes and posit some "next steps" required to develop self-management programs in the Australian context. Self-management and self-management support are key aspects of optimal chronic disease care, and are effective if implemented appropriately. Health literacy is the foundation for self-management programs and should be fostered within the whole population. ⋯ Because patient, carer, clinician and organisational engagement with self-management and self-management support programs are uneven, we need to prioritise activities designed to engage known hard-to-reach groups. We should strive to improve integration of self-management into clinical, educational and workplace contexts. Education and psychological theories can help guide self-management support.
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In April 2008, the Australian Government established the National Preventative Health Taskforce to develop a National Preventative Health Strategy by June 2009. The Strategy will provide a blueprint for tackling the burden of chronic disease currently caused by obesity, tobacco and excessive consumption of alcohol. The Taskforce has produced a discussion paper, Australia: the healthiest country by 2020. It presents a wide range of options, some of them contentious, to achieve this ambitious target.