A Cluster Randomised Controlled Trial of the Clinical and Cost-effectiveness of a 'whole Systems' Model of Self-management Support for the Management of Long- Term Conditions in Primary Care: Trial Protocol

Overview

Journal Implement Sci

Publisher Biomed Central

Specialty Health Services

Date 2012 Jan 28

PMID 22280501

Citations 30

Authors

Peter Bower

Anne Kennedy

David Reeves

Anne Rogers

Tom Blakeman

Carolyn Chew-Graham

Robert Bowen

Martin Eden

Caroline Gardner

Mark Hann

Victoria Lee

Rebecca Morris

Joanne Protheroe

Gerry Richardson

Caroline Sanders

Angela Swallow

David Thompson

Affiliations

Soon will be listed here.

Abstract

Background: Patients with long-term conditions are increasingly the focus of quality improvement activities in health services to reduce the impact of these conditions on quality of life and to reduce the burden on care utilisation. There is significant interest in the potential for self-management support to improve health and reduce utilisation in these patient populations, but little consensus concerning the optimal model that would best provide such support. We describe the implementation and evaluation of self-management support through an evidence-based 'whole systems' model involving patient support, training for primary care teams, and service re-organisation, all integrated into routine delivery within primary care.

Methods: The evaluation involves a large-scale, multi-site study of the implementation, effectiveness, and cost-effectiveness of this model of self-management support using a cluster randomised controlled trial in patients with three long-term conditions of diabetes, chronic obstructive pulmonary disease (COPD), and irritable bowel syndrome (IBS). The outcome measures include healthcare utilisation and quality of life. We describe the methods of the cluster randomised trial.

Discussion: If the 'whole systems' model proves effective and cost-effective, it will provide decision-makers with a model for the delivery of self-management support for populations with long-term conditions that can be implemented widely to maximise 'reach' across the wider patient population.

Trial Registration Number: ISRCTN: ISRCTN90940049.

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