Frameworks for self-management support for chronic disease: a cross-country comparative document analysis

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dc.contributor.authorO'Connel, Selena
dc.contributor.authorMc Carthy, Vera J. C.
dc.contributor.authorSavage, Eileen
dc.contributor.funderHealth Service Executive
dc.date.accessioned2018-08-29T15:47:19Z
dc.date.available2018-08-29T15:47:19Z
dc.date.issued2018
dc.description.abstractBackground: In a number of countries, frameworks have been developed to improve self-management support (SMS) in order to reduce the impact of chronic disease. The frameworks potentially provide direction for system-wide change in the provision of SMS by healthcare systems. Although policy formulation sets a foundation for health service reform, little is currently known about the processes which underpin SMS framework development as well as the respective implementation and evaluation plans. Methods: The aim of this study was to conduct a cross-country comparative document analysis of frameworks on SMS for chronic diseases in member countries of the Organisation for Economic Cooperation and Development. SMS frameworks were sourced through a systematic grey literature search and compared through document analysis using the Health Policy Triangle framework focusing on policy context, contents, actors involved and processes of development, implementation and evaluation. Results: Eight framework documents published from 2008 to 2017 were included for analysis from: Scotland, Wales, Ireland, Manitoba, Queensland, Western Australia, Tasmania and the Northern Territory. The number of chronic diseases identified for SMS varied across the frameworks. A notable gap was a lack of focus on multimorbidity. Common courses of action across countries included the provision of self-management programmes for individuals with chronic disease and education to health professionals, though different approaches were proposed. The 'actors' involved in policy formulation were inconsistent across countries and it was only clear from two frameworks that individuals with chronic disease were directly involved. Half of the frameworks had SMS implementation plans with timelines. Although all frameworks referred to the need for evaluation of SMS implementation, few provided a detailed plan. Conclusions: Differences across frameworks may have implications for their success including: the extent to which people with chronic disease are involved in policy making; the courses of action taken to enhance SMS; and planned implementation processes including governance and infrastructure. Further research is needed to examine how differences in frameworks have affected implementation and to identify the critical success factors in SMS policy implementation.en
dc.description.sponsorshipHealth Service Executive (Programme for Health Service Improvement)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid583
dc.identifier.citationO’Connell, S., Mc Carthy, V. J. C. and Savage, E. (2018) 'Frameworks for self-management support for chronic disease: a cross-country comparative document analysis', BMC Health Services Research, 18(1), 583 (10pp). doi: 10.1186/s12913-018-3387-0en
dc.identifier.doi10.1186/s12913-018-3387-0
dc.identifier.endpage10
dc.identifier.issn1472-6963
dc.identifier.journaltitleBMC Health Services Researchen
dc.identifier.startpage1
dc.identifier.urihttps://hdl.handle.net/10468/6660
dc.identifier.volume18
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urihttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3387-0
dc.rights© 2018, the Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectDocument analysisen
dc.subjectHealth policy analysisen
dc.subjectSelf-management supporten
dc.subjectChronic diseaseen
dc.titleFrameworks for self-management support for chronic disease: a cross-country comparative document analysisen
dc.typeArticle (peer-reviewed)en
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