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Joining Up Self-Care: evaluation of a PCT-wide programme of support for self-care

  • Alison Blenkinsopp (a1), Jeremy Holmes (a2), Gopa Mitra (a3) and Mike Pringle (a4)
Abstract
Background and Aim

Although there is existing activity within the NHS and local communities to support self-care there has been no previous attempt at integration across a Primary Care Trust (PCT). The Joining Up Self-Care (JUSC) study aimed to implement and evaluate such a programme.

Methods

Three self-care support modules for members of the public, together with a training course for primary care teams, were developed with, and implemented in, one PCT. The modules related to disease prevention (community-based coronary heart disease (CHD) prevention), care of people with long-term conditions (a disease-specific self-care skills training course for asthma) and the management of minor ailments aimed at mothers of children aged 3 months to 12 years (the ‘Pharmacy First’ service plus information booklets and campaigns). Postal questionnaires were completed by participants in CHD prevention (178), management of asthma (76) and minor ailments management (92), and by controls. A general population survey (n = 540) provided a comparison group for the CHD module and assessed general awareness of local self-care support. Four focus groups were held with mothers of young children. An audit of general practitioner (GP) records was conducted for consultations for minor ailments. Structured telephone interviews were conducted with 51 local health professionals and nine members of staff from the PCT.

Results

Participants in the CHD module reported significantly more risk-reducing behaviours. Participants in a disease-specific Expert Patient Programme (EPP) for people with asthma rated the course positively, were subsequently more confident about discussing asthma with their doctor and had fewer concerns about their asthma medicines. Most users of the ‘Pharmacy First’ minor ailments scheme reported positive feedback and an intent to use the service again in the future. There were no significant differences in numbers of GP consultations for minor ailments between intervention and control groups. Health professionals were generally positive about encouraging self-care. Many felt they were already doing this but had insufficient time to implement it. A Local Enhanced Service (LES) was successful in engaging local general practices with self-care. Some organizational development relating to self-care occurred within the PCT but integration across different directorates was not achieved.

Conclusions

The JUSC programme was associated with changes in self-reported CHD risk reduction behaviours, in confidence to manage asthma and fewer concerns about medication, and with more positive attitudes towards consulting a pharmacist for minor ailments. Key principles for future PCT self-care strategies were identified. Further work is needed to embed support for self-care across the PCT as an organization.

Copyright
Corresponding author
Correspondence to: Professor Alison Blenkinsopp, Medicines Management, School of Pharmacy, Keele University, Keele, Staffs ST5 5BG, UK. Email: a.blenkinsopp@keele.ac.uk
References
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Blakeman, T., Macdonald, W., Bower, P., Gately, C.Chew-Graham, C. 2006: A qualitative study of GPs’ attitudes to self-management of chronic disease. British Journal of General Practice 56, June, 407414.
Blenkinsopp, A.Dost, A. 2005: Self care support: baseline study of activity and development in self care support in PCTs and local areas. England: Department of Health.
Blenkinsopp, A.Dost, A. 2006: Support for self care in general practice and urgent care settings: a baseline study. England: Department of Health.
Blenkinsopp, A. and Noyce, P. 2002: Minor illness management in primary care: A review of community pharmacy NHS schemes. Keele University.
Bury, M., Newbould, J.Taylor, D. 2005: A rapid review of the current state of knowledge regarding lay led self-management of chronic illness. London: National Institute for Health and Clinical Excellence. Retrieved 20 August 2008 from http://www.nice.org.uk/nicemedia/pdf/lay_led_rapid_review_v10-FINAL.pdf
Coulter, A. 2006: Engaging patients in their health care. Picker Institute Europe. Retrieved 4 August 2008 from http://www.pickereurope.org/Filestore/Downloads/Six-country-study-6-4-06-web-version.pdf
Department of Health. 2005a: Self Care: a real choice. London: TSO.
Department of Health. 2005b: National Expert Patients Programme Internal Monitoring Report. London: TSO.
Department of Health. 2006a: Supporting people with long term conditions to self care: a guide to developing local strategies and good practice. London: TSO.
Hassell, K.Whittington, Z.Cantrill, J.Bates, F.Rogers, A. and Noyce, P. 2001: Managing demand: transfer of management of self limiting conditions from general practice to community pharmacies. BMJ 323, 146147.
Juniper, E.F., Guyatt, G.H., Willan, A.Griffith, L.E. 1994: Determining a minimal important change in a disease-specific quality of life questionnaire. Journal of Clinical Epidemiology 47, 8187.
Juniper, E.F., O’Byrne, P.M., Guyatt, G., Ferrie, P.King, D.R. 1999: Development and Validation of the Mini Asthma Quality of Life Questionnaire. European Respiratory Journal 14, 3238.
Kennedy, A., Rogers, A.Gately, C. 2005: Assessing the Introduction of the Expert Patients Programme into the NHS: a realistic evaluation of recruitment to a national lay-led self-care initiative. Primary Health Care Research & Development 6, 137148.
Leeds Metropolitan University. 2008: Self Care Project. Retrieved 4 August 2008 from http://www.lmu.ac.uk/health/selfcareproject/index.htm
Lindholm, L., Rosén, M., Weinehall, L.Asplund, K. 1996: Cost effectiveness and equity of a community based cardiovascular disease prevention programme in Norsjö, Sweden. Journal of Epidemiology and Community Health 50, 190195.
Merzel, C.D’Afflitti, J. 2003: Reconsidering community-based health promotion: promise, performance and potential. American Journal of Public Health 93, 557574.
Ritchie, J.Spencer, L. 1993: Qualitative data analysis for applied policy research. In Bryman, A. and Burgess, R., editors, Analysing qualitative data. London: Routledge, 173194.
Sheehy, C. Jones, L. 2003: Direct supply of medicines in Scotland: extended monitoring of a pilot scheme. Health & Community Care Research Programme, Scottish Executive Social Research, Research Findings no. 30.
Tudor-Smith, C., Nutbeam, D., Moore, L.Catford, J. 1998: Effects of the Heartbeat Wales programme over five years on behavioural risks for cardiovascular disease: quasi-experimental comparison of results from Wales and a matched reference area. British Medical Journal 316, 818822.
Wilson, P.M., Kendall, S.Brooks, F. 2006: Nurses’ responses to expert patients: the rhetoric and reality of self-management in long-term conditions: a grounded theory study. International Journal of Nursing Studies 43, 803818.
Wilson, P.M., Kendall, S.Brooks, F. 2007: The Expert Patients Programme: a paradox of patient empowerment and medical dominance. Health and Social Care in the Community 15, 426438.
Working in Partnership Programme/Proprietary Association of Great Britain. 2006: Self care aware: Joining Up Self Care in the NHS. Evaluation of the Joining Up Self Care project in Erewash PCT. Final report.
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Primary Health Care Research & Development
  • ISSN: 1463-4236
  • EISSN: 1477-1128
  • URL: /core/journals/primary-health-care-research-and-development
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