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Self-management support.

This is the ninth in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

There is growing awareness of the importance of supporting patient self-management as part of a comprehensive approach to caring for people with chronic conditions. Fifteen minutes with a provider every few months contributes less to patient outcomes than what the patient does every day. This month's article describes some elements of AHRQ's Self-Management Support Resource Library, a collection of materials and tools produced by AHRQ and others.

It was developed to help primary care team members learn about self-management support and develop their self-management support skills in working with chronically ill patients. To help practices improve this essential aspect of comprehensive primary care, the resources address what self-management support is, how to implement it, and why it is important. A good place to start is with AHRQ-produced videos that examine the "what, why, and how" of self-management support from the perspectives of experienced primary care teams across the country. These videos also are available on AHRQ Primary Care YouTube channel.

The Library's resources also include materials from other sources. These include Helping patients help themselves: How to implement self-management support, a paper from the California Health Care Foundation. It defines self-management support (SMS), provides case studies of primary care practices that have implemented SMS, and discusses the business case for SMS. Case studies include settings such as primary care practices, behavioral health programs, and telephone consultations featuring SMS models that rely on the actions of nurses, medical assistants, community health workers (promotoras), and health coach volunteers. "Helping patients take charge of their chronic illnesses" is an article from the American Academy of Family Physicians that introduces SMS concepts, provides a rationale for patient self-management, and gives an example of how to empower patients with information. It makes a case for shifting from an acute-care model to a patient-centered care model that includes SMS.

Enhancing the patient's ability to manage medication is important. Clearly stating medication instructions improves patient understanding and possibly reduces errors while improving adherence. Explicit and standardized prescription medicine instructions offers tested instructions to simplify complex medicine regimens by using standard time periods for administration. These instructions have been translated into Chinese, Korean, Russian, Spanish, and Vietnamese.

Another aspect teaches how to create an easy-to-use "pill card" to ease keeping track of medicines. Step-by-step instructions, sample clip art, and suggestions for design and use will help to customize the card.

AHRQ offers resources to improve health literacy. These were described in more detail in the 5th article in this series (January 2018). In brief, these resources include The Health Literacy Universal Precautions Tool-kit--2nd edition and its companion guide, Implementing the Health Literacy Universal Precautions Toolkit: Practical Ideas for Primary Care Practices. In addition, the Patient Education Materials Assessment Tool features a systematic method to evaluate and compare how understandable and actionable patient education materials are.

All of this can come with recertification credit. The Patient Self-Management Support of Chronic Conditions: Framework for Clinicians Seeking Recertification Credit (Maintenance of Certification, Part IV & Performance Improvement-Continuing Medical Education) provides a free, self-contained framework for clinicians to design their own quality improvement project.


Dr. Genevro is a health scientist at AHRQ.

Dr. Ganiats is director of the National Center for Excellence in Primary Care Research at AHRQ.

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Title Annotation:AHRQ Practice Toolbox
Author:Genevro, Janice L.
Publication:Family Practice News
Geographic Code:1USA
Date:May 15, 2018
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