Exploring Factors that Influence Patient Engagement in Self-Management of Chronic Diseases
Patient engagement is a partnership between patients, families, and health care providers to achieve positive health care outcomes. It is especially important for patients with chronic diseases, such as diabetes, asthma, or depression, who need to manage their conditions on a daily basis. Self-management is the ability of patients to monitor and control their symptoms, adhere to treatment plans, and adopt healthy behaviors that can improve their quality of life and reduce health care costs. However, many patients face barriers to effective self-management, such as low health literacy, lack of social support, or limited access to resources. Therefore, health care providers need to implement strategies that can enhance patient engagement and support self-management in patients with chronic diseases.
Some of the strategies that have been shown to improve patient engagement and self-management include:
– Self-management support: This involves providing patients with education, coaching, feedback, and tools that can help them develop problem-solving skills, self-efficacy, and confidence in managing their conditions. Self-management support can be delivered through individual or group sessions, phone calls, web-based platforms, or mobile applications. Self-management support has been found to reduce hospitalizations, emergency department use, and overall health care costs, especially for patients with diabetes [1] [2] [3].
– Shared decision-making: This involves engaging patients in a collaborative process of making informed choices about their treatment options, based on their preferences, values, and goals. Shared decision-making can be facilitated by using decision aids, such as pamphlets, videos, or online tools, that provide information about the benefits and risks of different interventions. Shared decision-making has been found to increase patient satisfaction, adherence, and outcomes, especially for patients with cancer [1] [4].
– Patient activation: This refers to the degree to which patients have the knowledge, skills, and confidence to manage their own health and health care. Patient activation can be measured by using a tool called the Patient Activation Measure (PAM), which assesses four levels of activation: (1) believing that one’s role is important; (2) having the confidence and knowledge to take action; (3) taking action to maintain and improve one’s health; and (4) staying the course even under stress. Patient activation can be enhanced by providing tailored feedback, education, and coaching that address the specific needs and goals of each patient. Patient activation has been found to be associated with improved self-care activities, self-management behaviors, health outcomes, adherence, quality of life, fewer hospitalizations, and lower health care costs in people with chronic diseases [5].
These strategies are not mutually exclusive and can be integrated into a comprehensive approach that addresses the multiple dimensions of patient engagement and self-management. However, there is still a need for more research on the best ways to implement these strategies in different settings and populations, and on the long-term effects of these interventions on patient outcomes and health care utilization.
Works Cited
[1] Aboumatar H., Pitts S., Sharma R., et al. Patient engagement strategies for adults with chronic conditions: an evidence map. Systematic Reviews 2022; 11:39. https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-021-01873-5
[2] Coleman M.T., Newton K.S. Supporting self-management in patients with chronic illness. American Family Physician 2005; 72(8):1503-1510. https://www.aafp.org/pubs/afp/issues/2005/1015/p1503.html
[3] Health Catalyst. Why patient engagement is critical for chronic disease management. 2019. https://www.healthcatalyst.com/news/why-patient-engagement-is-critical-for-chronic-disease-management
[4] Agency for Healthcare Research and Quality. Strengthening patient engagement to improve care and shared decision making. 2020. https://digital.ahrq.gov/2020-year-review/research-summary/strengthening-patient-engagement-improve-care-and-shared-decision-making
[5] Ong B.N., Rogers A., Kennedy A., et al. Patient activation: The cornerstone of effective self-management in long-term conditions? Healthcare 2020; 2(1):12. https://www.mdpi.com/2673-8236/2/1/12
