Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review

Background: Patients with advanced cancer are increasingly expected to self-manage. Thus far, this topic has received little systematic attention. Aim: To summarise studies describing self-management strategies of patients with advanced cancer and associated experiences and personal characteristics. Also, to summarise attitudes of relatives and healthcare professionals towards patient self-management. Design: A systematic review including non-experimental quantitative and qualitative studies. Data were analysed using critical interpretive synthesis. Included studies were appraised on methodological quality and quality of reporting. Data sources: MEDLINE, Embase, Cochrane Central, PsycINFO, CINAHL, Web of Science and Google Scholar (until 11 June 2019). Results: Of 1742 identified articles, 31 moderate-quality articles describing 8 quantitative and 23 qualitative studies were included. Patients with advanced cancer used self-management strategies in seven domains: medicine and pharmacology, lifestyle, mental health, social support, knowledge and information, navigation and coordination and medical decision-making (29 articles). Strategies were highly individual, sometimes ambivalent and dependent on social interactions. Older patients and patients with more depressive symptoms and lower levels of physical functioning, education and self-efficacy might have more difficulties with certain self-management strategies (six articles). Healthcare professionals perceived self-management as desirable and achievable if based on sufficient skills and knowledge and solid patient–professional partnerships (three articles). Conclusion: Self-management of patients with advanced cancer is highly personal and multifaceted. Strategies may be substitutional, additional or even conflicting compared to care provided by healthcare professionals. Self-management support can benefit from an individualised approach embedded in solid partnerships with relatives and healthcare professionals.

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Do pain management websites foster self-management support for people with persistent pain? A scoping review

Patient Education and Counseling ◽

10.1016/j.pec.2019.04.009 ◽

2019 ◽

Vol 102 (9) ◽

pp. 1590-1601 ◽

Cited By ~ 2

Author(s):

Hemakumar Devan ◽

Meredith A. Perry ◽

Angelique van Hattem ◽

Greg Thurlow ◽

Sam Shepherd ◽

...

Keyword(s):

Pain Management ◽

Scoping Review ◽

Persistent Pain ◽

Self Management ◽

Management Support

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Patients’ and healthcare professionals’ perceptions of self-management support interactions: Systematic review and qualitative synthesis

Chronic Illness ◽

10.1177/1742395317710082 ◽

2017 ◽

Vol 14 (2) ◽

pp. 79-103 ◽

Cited By ~ 24

Author(s):

Marika Franklin ◽

Sophie Lewis ◽

Karen Willis ◽

Helen Bourke-Taylor ◽

Lorraine Smith

Keyword(s):

Systematic Review ◽

Healthcare Professionals ◽

Care Delivery ◽

Individual Responsibility ◽

Self Management ◽

Chronic Obstructive ◽

Traditional Model ◽

Management Support ◽

Model Of Care ◽

Qualitative Synthesis

Objective To review studies examining the experience of self-management support in patient–provider interactions and the shaping of goals through interactions. Methods We undertook a systematic review and thematic synthesis of the qualitative literature. We searched six databases (2004–2015) for published studies on the provision of self-management support in one-to-one, face-to-face, patient–provider interactions for obesity, type 2 diabetes mellitus and chronic obstructive pulmonary disease, with 14 articles meeting inclusion criteria. Results Themes identified from studies were (1) dominance of a traditional model of care, encompassing the provision of generic information, exclusion of the psychosocial and temporal nature of interactions and (2) a context of individual responsibility and accountability, encompassing self-management as patients’ responsibility and adherence, accountability and the attribution of blame. Interactions were constrained by consultation times, patient self-blame and guilt, desire for autonomy and beliefs about what constitutes ‘effective’ self-management. Discussion Encounters were oriented towards a traditional model of care delivery and this limited opportunity for collaboration. These findings suggest that healthcare professionals remain in a position of authority, limiting opportunities for control to be shared with patients and shared understandings of social context to be developed.

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Is the task-shifting in self-management support effective? A systematic review and meta-analysis

European Journal of Public Health ◽

10.1093/eurpub/ckw164.035 ◽

2016 ◽

Vol 26 (suppl_1) ◽

Author(s):

A Massimi ◽

C De Vito ◽

I Brufola ◽

A Corsaro ◽

C Marzuillo ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Task Shifting ◽

Self Management ◽

Management Support

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Self-management interventions for Type 2 Diabetes: systematic review protocol focusing on patient workload and capacity support

Wellcome Open Research ◽

10.12688/wellcomeopenres.17238.1 ◽

2021 ◽

Vol 6 ◽

pp. 257

Author(s):

Peter Hanlon ◽

Iona Bryson ◽

Holly Morrison ◽

Qasim Rafiq ◽

Kasey Boehmer ◽

...

Keyword(s):

Systematic Review ◽

Type 2 Diabetes ◽

Hospital Admissions ◽

Macrovascular Disease ◽

Self Management ◽

Management Support ◽

Patient Capacity ◽

Management Interventions ◽

The Impact

Introduction: People living with type 2 diabetes undertake a range of tasks to manage their condition, collectively referred to as self-management. Interventions designed to support self-management vary in their content, and efficacy. This systematic review will analyse self-management interventions for type 2 diabetes drawing on theoretical models of patient workload and capacity. Methods and analysis: Five electronic databases (Medline, Embase, CENTRAL, CINAHL and PsycINFO) will be searched from inception to 27th April 2021, supplemented by citation searching and hand-searching of reference lists. Two reviewers will independently review titles, abstracts and full texts. Inclusion criteria include Population: Adults with type 2 diabetes mellitus; Intervention: Randomised controlled trials of self-management support interventions; Comparison: Usual care; Outcomes: HbA1c (primary outcome) health-related quality of life (QOL), medication adherence, self-efficacy, treatment burden, healthcare utilization (e.g. number of appointment, hospital admissions), complications of type 2 diabetes (e.g. nephropathy, retinopathy, neuropathy, macrovascular disease) and mortality; Setting: Community. Study quality will be assessed using the Effective Practice and Organisation of Care (EPOC) risk of bias tool. Interventions will be classified according to the EPOC taxonomy and the PRISMS self-management taxonomy and grouped into similar interventions for analysis. Clinical and methodological heterogeneity will be assessed within subgroups, and random effects meta-analyses performed if appropriate. Otherwise, a narrative synthesis will be performed. Interventions will be graded on their likely impact on patient workload and support for patient capacity. The impact of these theoretical constructs on study outcomes will be explored using meta-regression. Conclusion This review will provide a broad overview of self-management interventions, analysed within the cumulative complexity model theoretical framework. Analyses will explore how the workload associated with self-management, and support for patient capacity, impact on outcomes of self-management interventions. Registration number: PROSPERO CRD42021236980.

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