Sarah Dineen-Griffin|Victoria García?Cárdenas|Kylie Williams|Shalom I. Benrimoj
Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice
University of Technology Sydney|University of Technology Sydney|University of Technology Sydney|University of Sydney
background primary health professionals well positioned support delivery patient selfmanagement evidencebased structured capacity need exists better understand active components required effective selfmanagement support might delivered within primary care training system changes would subsequently needed objectives 1 examine selfmanagement support interventions primary care health outcomes wide range diseases compared usual standard care 2 identify effective strategies facilitate positive clinical humanistic outcomes setting method systematic review randomized controlled trials evaluating selfmanagement support interventions conducted following cochrane handbook prisma guidelines published literature systematically searched inception june 2019 pubmed scopus web science eligible studies assessed effectiveness individualized interventions followup delivered facetoface adult patients condition primary care compared usual standard care matrices developed mapped evidence components intervention methodological quality included studies appraised results 6510 records retrieved 58 studies included final qualitative synthesis findings reveal structured patientprovider exchange required primary care including oneonone patientprovider consultation ongoing follow provision selfhelp materials interventions tailored patient needs may include combinations strategies improve patients disease treatment knowledge independent monitoring symptoms encouraging selftreatment personalized action plan response worsening symptoms exacerbations psychological coping stress management strategies enhancing responsibility medication adherence lifestyle choices followup may include tailored feedback monitoring progress respect patient set healthcare goals honing problemsolving decisionmaking skills theoretical models provided strong base effective sms interventions positive outcomes effective sms included improvements clinical indicators healthrelated quality life selfefficacy confidence selfmanage disease knowledge control sms model developed sets foundation design evaluation practical strategies construct selfmanagement support interventions primary healthcare practice conclusions findings provide primary care professionals evidencebased strategies structure deliver sms practice collaborative partnership approach widely applied future research build findings optimal sms service design upskilling healthcare providers effectively support patients collaborative process