Supporting self-management for patients with complex medical needs: recommendations of a working group.
Increasing numbers of persons live with complex chronic medical needs and are at risk for poor health outcomes. These patients require unique self-management support, as they must manage many, often interacting, tasks. As part of a conference on Managing Complexity in Chronic Care sponsored by the Department of Veterans Affairs, a working group was convened to consider self-management issues specific to complex chronic care. In this paper, we assess gaps in current knowledge on self-management support relevant to this population, report on the recommendations of our working group, and discuss directions for future study. We conclude that this population requires specialized, multidimensional self-management support to achieve a range of patient-centred goals. New technologies and models of care delivery may provide opportunities to develop this support. Validation and quantification of these processes will require the development of performance measures that reflect the needs of this population, and research to prove effectiveness.
Bayliss
E A
EA
Clinical Research Unit, Kaiser Permanente, PO Box 378066, Denver, CO 80237-8066, USA. Elizabeth.bayliss@kp.org
Bosworth
H B
HB
Noel
P H
PH
Wolff
J L
JL
Damush
T M
TM
Mciver
L
L
D002908:Chronic Disease / Q000628:therapy*; D003695:Delivery of Health Care; D006287:Health Planning Guidelines; D006291:Health Policy; D006301:Health Services Needs and Demand; D006801:Humans; D010817:Physician-Patient Relations; D012648:Self Care