Chapter 30. What is the Evidence That Increasing Participation of Individuals in Self-Management Improves the Processes and Outcomes of Care?

  1. R. Williams2,
  2. W. Herman3,
  3. A.-L. Kinmonth5 and
  4. N. J. Wareham4
  1. Debra Roter1 and
  2. Ann-Louise Kinmonth5

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch30

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Roter, D. and Kinmonth, A.-L. (2002) What is the Evidence That Increasing Participation of Individuals in Self-Management Improves the Processes and Outcomes of Care?, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch30

Editor Information

  1. 2

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 3

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 4

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 5

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. 1

    Department of Health Policy and Management, Johns Hopkins School of Public Health, 624 N Broadway, Rm 750, Baltimore, MD 21205, USA

  2. 5

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

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Keywords:

  • compliance;
  • self-management;
  • patient engagement;
  • patient participation;
  • patient activation;
  • patient empowerment;
  • communication;
  • education

Summary

Traditionally, assessment of the needs of patients with diabetes and choice of treatment options has relied on the judgement of physicians, but there is now a move towards greater patient involvement. Effective management of diabetes requires regular glucose testing and taking of medications, as well as adoption of healthy lifestyle behaviours. Active involvement of the patient in the decision making should result in greater compliance with these requirements. This chapter reviews the evidence linking levels of patient engagement in medical visit communication and self-management to diabetes-related outcomes. There are three levels of patient engagement: participation, activation and empowerment. Although such approaches seem to be successful, the reasons for such success are unclear and require further evaluations of clearly defined interventions. Meanwhile, several principles are emerging that can inform better clinical practice: to listen to the patient's perspective, to provide information that is useful and relevant, to negotiate a plan and anticipate problems, to offer ongoing monitoring of compliance and compliance difficulties and to provide emotional support to the patient.