Promoting self-management of multiple sclerosis in primary care

BackgroundA considerable proportion of GPs’ workload is dermatological. It is important to investigate what common skin conditions encountered in primary care can be self-managed, in an effort to alleviate the burden on primary care.AimThe purpose of the audit was to identify the proportion of consultations that are dermatological in nature and analyse potential for self-management by patients.MethodData was collected using the patient electronic record system (EMIS) in general practice. A search was made for all consultations from the 17 April to 15 May 2019, which included all new presenting complaints that were dermatological in nature. The criteria for self-management included advising over the counter (OTC) medication or reassurance. On the other hand, a case was deemed not self-manageable if prescription only medication (POM) was prescribed or if a referral to dermatology was made.ResultsThere were a total of 2175 consultations, where 246 (11.31%) cases were dermatological. Of the 246, 80 cases (32.5%) could be self-managed. There were 46 different dermatological presenting complaints of which the 5 most common included: rash (51 cases), dermatitis (44 cases), acne vulgaris (13 cases), moles (12 cases), dry skin (11 cases). None of the acne or moles cases could be self-managed, whereas 23%, 68.2%, 72.7% of rashes, dermatitis, and dry skin cases, respectively, could be self-managed.ConclusionCertain dermatological conditions have more potential for self-management than others. Research into teledermatology as a means of addressing patient concern and providing clinical information is important in order to reduce unnecessary consultations.

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Faculty Opinions recommendation of Optimized antidepressant therapy and pain self-management in primary care patients with depression and musculoskeletal pain: a randomized controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1161063.621527 ◽

2009 ◽

Author(s):

Dan Blazer

Keyword(s):

Primary Care ◽

Randomized Controlled Trial ◽

Musculoskeletal Pain ◽

Controlled Trial ◽

Antidepressant Therapy ◽

Self Management ◽

Randomized Controlled ◽

Primary Care Patients

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Attendance, activation and health profiles of participants, a prospective study on a regional cardiometabolic disease self-management program in Laval, Canada

BMC Public Health ◽

10.1186/s12889-021-10558-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Magali Girard ◽

Janusz Kaczorowski ◽

Marie-Thérèse Lussier ◽

Vivianne Martin

Keyword(s):

Primary Care ◽

Waist Circumference ◽

Prospective Study ◽

Cardiovascular Health ◽

Descriptive Analysis ◽

Management Program ◽

Self Management ◽

Controlled Study ◽

Cardiometabolic Disease ◽

A Prospective Study

Abstract Background Chronic diseases are responsible for over 70% of all deaths globally. While some self-management programs have been shown to be efficacious in preventing or altering trajectories for some chronic conditions, scaling-up and sustaining such programs beyond tightly-controlled study conditions remain a major challenge. CISSS-Laval partnered with the Cardiovascular Health Awareness Program team to co-develop Cible-santé/prévention and evaluate the first cohort of participants enrolled in the program, in order to better understand the program’s implementation and scope. The objective of the current study was to describe the profile of attendees and the level of engagement of participants in a new, region-wide cardiometabolic disease self-management program offered in Laval, Canada. Methods This was a prospective study with no comparison group. Potential participants were identified and referred to the program from April to December 2015 by their primary care health professional practicing in one of the city’s interdisciplinary primary care clinics. They had their blood pressure, waist circumference and body mass index measured by trained volunteers, and completed a questionnaire on health habits, level of activation and the risk of developing prediabetes and type 2 diabetes over the next 10 years. Results A descriptive analysis of the first cohort of 141 Cible-Santé/prévention participants showed very low attendance. Furthermore, only 1 in 10 of enrolled participants completed the full program. The program typically attracted adults with some risk factors associated with their conditions (high waist circumference, obesity), but with an already high level of knowledge, skills and confidence to participate in self-management activities. Conclusion This study provides a portrait of new participants to a self-management cardiometabolic disease program, which highlights the potential of supporting patients ready to make changes but also exposes the difficulty of attracting a larger number and diversity of participants and in encouraging completion of the program.

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The International Classification of Functioning, Disability, and Health (ICF) as a community participation model for people with multiple sclerosis: A hierarchical regression analysis

Australian Journal of Rehabilitation Counselling ◽

10.1017/jrc.2020.15 ◽

2020 ◽

Vol 26 (2) ◽

pp. 55-72

Author(s):

Joseph Pfaller ◽

Fong Chan ◽

Kanako Iwanaga ◽

Jia-Rung Wu ◽

Stuart Rumrill ◽

...

Keyword(s):

Multiple Sclerosis ◽

Regression Analysis ◽

Community Participation ◽

International Classification Of Functioning ◽

Self Management ◽

Hierarchical Regression ◽

Personal Factors ◽

Disability And Health ◽

The Relationship

AbstractMultiple sclerosis (MS) is a central nervous system disorder that impacts more than 400,000 people in the U.S. The disease results in multiple functional impairments that are diverse and varied across individuals. Additonally, MS has a profound impact on community participation which, like other rehabilitation outcomes, cannot be explained on the basis of functional limitations alone. The purpose of this study was to develop and evaluate a model of community participation for people living with MS using the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) framework. The model focused on the roles that personal factors have as predictors of community participation, while also serving as mediators and moderators for the relationship between activity limitation and participation. Results from the hierarchical regression analysis indicated that demographic characteristics (i.e. MS type), personal factors (i.e. core self-evaluations (CSE), MS self-management, resilience, and social skills), and activity limitations accounted for 64% of the variance in participation. Further, mediation analysis indicated that CSE mediated the relationship between activity limitation and community participation. Finally, moderation analysis indicated an interaction effect between educational attainment and MS self-management. Implications for future research in rehabilitation and clinical application are discussed.

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