Patient self-management tools

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Introduction[edit | edit source]

With the need for people to be able to get efficient, less costly and customized solutions, patient self-management has become a priority in health. In order to achieve this goal, tools have emerged within the healthcare system to try and open new perspectives regarding one’s implication into one's own health.

For the National Health Service in England (NHS) , self-management is described as the “ways that health and care services encourage, support and empower people to manage their ongoing physical and mental health conditions themselves.[1]” In developed countries, health is no longer seen as a restrained physical condition, but as a global feeling of well-being involving mental health, social connections and any other meaningful events that one perceives as impactful.

Furthermore, researches have shown how implication in health could play a huge role in the motivation, response and therefore outcome of the treatment.[2]It is however to be noted that the careful selection of the tool used, plays a predominant role in the potential effect on treatment.

Due to they long term costs and effect on peoples life, most researches have been based on the self-management of chronic diseases such as diabetes and hypertension. With new technologies arising, this will hopefully open up the room for more sectors, especially in prevention.

Segmentation of patient management tools[edit | edit source]

In healthcare, the segmentation of the different tools plays an important role in how they can be used within treatment. On a two ways axis, technological skills and the level of autonomy of the patient will be taken into account in order to draw an optimal overview of the possible solutions.[3]

[4]Scheme of patient self-management tools segmentation adapted from Patient self-management tools: An overview [Internet]. California Health Care Foundation. 2005 [cited 2022 Nov 27].

Subordinate patient management tools[edit | edit source]

With subordinate tools, the patient is asked for limited,or no effort regarding his treatment. Mainly used in prevention, examples of subordinate tools can be surveillance tools for elderlies subject to falls or dementia. Other patients with constant health risks, such as repeated heart failure, can also see advantages to those types of technologies. With video, sound recording or live button to call 112, those tools are necessary when the risk of staying home, out of care facilities, are high but not binding.

Structured patient management tools[edit | edit source]

On the other hand, structured patient management tools demand a further implication from the patient. No help is provided without the active patient implication into the process. Such tools have grown exponentially with covid, bringing services such as telemedecine [5] and online appointment making to greater levels.

Collaborative patient management tools[edit | edit source]

Associated with the shared-decision making process, collaborative tools have been used for now some years on chronic disease treatments such as diabetes type I . Examples of those types of tools can be seen with self glucose level testing or other home testing materials that are then used both by patient for personal adaptations and practitioner for treatment evolution insights.

Autonomous patient management tools[edit | edit source]

Autonomous tools have been mainly influenced by the wellness sector with people wanting more and more to be able to have quick solutions to their problems, as well as being reassured by easy to digest informations. Such tools can go from health blogs to books on how to treat certain pains but can also be seen as devices for instance like assisted AED that can be used by anyone with no mandatory previous knowledge.

Mobile health in patient-self management[edit | edit source]

Mhealth (short for mobile health) is often defined as the use of digital devices such as smartphones and tablets into the health sector. Used mainly to support practitioners into the follow-up of patients, it has started to emerge as more customized solutions for collaborative, and even autonomous, personal fitness and health trackers.

[6]

Advantages and barriers[edit | edit source]

Advantages to using patient self-management tools[edit | edit source]

Though their relative novelty, patient self-management tools have shown to be a good alternative to certain in-facility care. Those are some reasons why :

  • They have shown to be leading to less risks then conventional care even on low literacy patient. [7]
  • They create a strong implication of patient into owns health, leading to a stronger motivation. [8]
  • They enable a more precise health follow-up for practitioners in response to the patient's feedbacks ( ex : daily glucose level).
  • They can lead to reduce significantly the costs associated with chronic diseases.[9]

Barriers to using patient self-management tools[edit | edit source]

On the other hand, due to the new approach they bring to healthcare as well as the few current researches that are available, patient self-management tools should be used carefully. Some barriers that can occur are :

  • Patient lack of communication and feedback, making the management hard to assess for the health professional.
  • The lack of access to internet in some part of the world such as southern and eastern Asia, and in Africa.[10]
  • Patient's low health literacy, even in richer countries. Moreover, this low health literacy seems to corroborate with the need of seeking more often health services help. [11]

Other barriers such as the patient's "difficulty of coping", emotional situation and mood also have shown to further enhance the vision that self-management of patient is a necessary skill to train for healthcare professionals. [12]


References[edit | edit source]

  1. England NHS. NHS England » Tools to implement supported self-management [Internet]. Nhs.uk. [cited 2022 Nov 25].
  2. Glynn L, Casey M, Walsh J, Hayes PS, Harte RP, Heaney D. Patients’ views and experiences of technology based self-management tools for the treatment of hypertension in the community: A qualitative study. BMC Fam Pract [Internet]. 2015;16(1):119.
  3. Patient self-management tools: An overview [Internet]. California Health Care Foundation. 2005 [cited 2022 Nov 27].
  4. Patient self-management tools: An overview [Internet]. California Health Care Foundation. 2005 [cited 2022 Nov 27].
  5. Bradford WD. Telemedicine and telehealth: Principles, policies, performance and pitfalls by Adam W. darkins and Margaret A. cary. Free association books, London, 2000. No. Of pages 316. ISBN 1-853-43518-X. Health Econ [Internet]. 2001;10(7):681–2.
  6. MHealth Evidence - NIH, Oct 21, 2014
  7. DeWalt DA, Malone RM, Bryant ME, Kosnar MC, Corr KE, Rothman RL, et al. A heart failure self-management program for patients of all literacy levels: a randomized, controlled trial [ISRCTN11535170]. BMC Health Serv Res [Internet]. 2006;6(1):30.
  8. Glynn L, Casey M, Walsh J, Hayes PS, Harte RP, Heaney D. Patients’ views and experiences of technology based self-management tools for the treatment of hypertension in the community: A qualitative study. BMC Fam Pract [Internet]. 2015;16(1):119.
  9. Marshall T. Clinical and economic consequences of patients as producers. J Public Health Med [Internet]. 1996;18(3):377–8.
  10. Digital around the world [Internet]. DataReportal – Global Digital Insights. [cited 2022 Nov 27].[1]
  11. Sørensen K, Pelikan JM, Röthlin F, Ganahl K, Slonska Z, Doyle G, et al. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health [Internet]. 2015;25(6):1053–8.
  12. Baumgardner DJ. Patient self-management: Tools and barriers. J Patient Cent Res Rev [Internet]. 2018 Autumn;5(4):253–5.