A Cluster randomised controlled trial of the clinical and cost-effectiveness of a 'whole systems' model of self-management support for the managment of long-term conditions in primary care: trial protocol

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

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    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. © 2012 Bower et al; licensee BioMed Central Ltd.
    Original languageEnglish
    Article number7
    Number of pages13
    JournalImplementation Science
    Volume7
    Issue number7
    DOIs
    Publication statusPublished - 26 Jan 2012

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