|
Strategy
|
Method
|
Research
Evidence
|
|
Improve
Information
+
|
Develop
information with patients that is relevant, accessible
and uses both lay experiences and traditional evidence-based
knowledge.
|
People
draw on a wide range of 'official' and alternative information
sources2.
Guidebooks have been developed with patients3.
Patients value and find therapeutic views and experiences
of others4. |
|
Guided
self-management
+
|
Negotiate
and write down a self-management plan that patients
can refer to when making decisions about treatment and
the need for service contact.
|
The
NPCRDC research has shown this approach:
-
does not increase morbidity
- improves clarity of communication and
- leads to greater satisfaction
because
patients prefer self-management and self-referral
to conventional follow-up5.
|
|
Improve
access to services
+
|
Change
access arrangements to health services by enabling patients
to self-refer to hospital clinics when they need advice
or treatment.
|
Past
experience of service use impacts on future use and
illness management, people self-ration and are influenced
by perceptions of rationing in the NHS6.
Patients
with IBD prefer a system of open access which reduces
doctor visits5.
|
|
Change
professional response
|
For
effective health care in chronic disease, patients need
to work in partnership with their doctor, a patient-centred
consultation is one way to achieve this.
|
Patients
are experts in the individual experience of their illness,
this complements the professional's expertise about
disease and illness states. Both patients and consultants
place a high value on their relationship, the use of
patient infromation is enhanced if consultants are involved
in its dissemination and use4.
|
1 Kennedy
AP, Nelson E, Reeves D, et al. RCT to assess the impact
of a
package comprising a patient orientated, evidence based
self-help guidebook and patient centred consultations on
disease management and satisfaction in IBD. Health Technology
Assessment 2002;
2
Rogers A, Hassell K, Nicholaas G. Demanding Patients?
Analysing the use of Primary Care. Open University,
1999.
3 Kennedy
AP, Robinson JA, Thompson DG, Wilkin D. Development of a
Guidebook to Promote Patient Participation in the Management
of Ulcerative Colitis. Health and Social Care in the
Community 1999;7:177-186.
4 Kennedy
AP, Rogers A. Improving patient involvement in chronic disease
management: the views of patients, GPs and specialists on
a guidebook for ulcerative colitis. Patient Education
and Counseling 2002; in press
5 Robinson
A, Wilkin D, Thompson DG, Roberts C. Guided self-management
and patient-directed follow-up of ulcerative colitis: a
randomised trial. The Lancet 2001; 358:976-981.
6 Rogers
A, Entwistle V, Pencheon D. A Patient Led NHS: Managing
Demand at the Interface Between Lay and Primary Care. British
Medical Journal 1998;316:1816-1819.
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