TY  - JOUR
A1  - Elissen, Arianne
A1  - Nolte, Ellen
A1  - Knai, Cécile
A1  - Brunn, Matthias
A1  - Chevreul, Karine
A1  - Conklin, Annalijn
A1  - Durand-Zaleski, Isabelle
A1  - Erler, Antje
A1  - Flamm, Maria
A1  - Frølich, Anne
A1  - Fullerton, Birgit
A1  - Jacobsen, Ramune
A1  - Saz-Parkinson, Zuleika
A1  - Sarria-Santamera, Antonio
A1  - Sönnichsen, Andreas
A1  - Vrijhoef, Hubertus
T1  - Is Europe putting theory into practice? : a qualitative study of the level of self-management support in chronic care management approaches
T2  - BMC health services research
N2  - Background: Self-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice.
Methods: We conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals’ views on the implementation of self-management support in practice.
Results: Self-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients’ medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture.
Conclusions: Although collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes.
KW  - Chronic illness
KW  - Disease management
KW  - Self-management support
KW  - Comparative study
KW  - Qualitative research
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/44215
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-442158
SN  - 1472-6963
N1  - © 2013 Elissen et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
VL  - 13
IS  - Art. 117
SP  - 1
EP  - 9
PB  - BioMed Central
CY  - London
ER  -