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BioMed Central, Implementation Science, 1(7), 2012

DOI: 10.1186/1748-5908-7-7

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A cluster randomised controlled trial of the clinical and cost-effectiveness of a 'whole systems' model of self-management support for the management of long- term conditions in primary care: trial protocol

Journal article published in 2012 by Peter Bower, Anne Kennedy, David Reeves ORCID, Anne Rogers, Tom Blakeman, Carolyn Chew-Graham, Anne Kennedy David Reeves Anne Rogers Tom Blakeman Carolyn Chew-Graham Robert Bowen Martin Eden Caroline Gardner Mark Hann Victoria Lee Rebecca Morris Joanne Protheroe Gerry Richardson Caroline Sanders Angela Swallow and David Thompson Peter Bower, Robert Bowen, Martin Eden ORCID, Caroline Gardner ORCID, Anne Kennedy1* David Reeves1 Rogers1 Tom Blakeman1 Carolyn Chew-Graham1 Robert Bowen1 Martin Eden1 Caroline Gardner1 Mark Hann1 Victoria Lee1 Rebecca Morris1 Joanne Protheroe2 Gerry Richardson3 Sanders1 Angela Swallow1 and David Thompson4 Peter Bower1, Mark Hann, Kennedy A Reeves D Rogers A Blakeman A Chew-Graham C Bowen A Eden M Gardner C Hann M Lee V Morris R Protheroe J Richardson G Sanders C Swallow A Thompson D. Bower P., Victoria Lee, Rebecca Morris and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Abstract Background Patients with long-term conditions are increasingly the focus of quality improvement activities in health services to reduce the impact of these conditions on quality of life and to reduce the burden on care utilisation. There is significant interest in the potential for self-management support to improve health and reduce utilisation in these patient populations, but little consensus concerning the optimal model that would best provide such support. We describe the implementation and evaluation of self-management support through an evidence-based 'whole systems' model involving patient support, training for primary care teams, and service re-organisation, all integrated into routine delivery within primary care. Methods The evaluation involves a large-scale, multi-site study of the implementation, effectiveness, and cost-effectiveness of this model of self-management support using a cluster randomised controlled trial in patients with three long-term conditions of diabetes, chronic obstructive pulmonary disease (COPD), and irritable bowel syndrome (IBS). The outcome measures include healthcare utilisation and quality of life. We describe the methods of the cluster randomised trial. Discussion If the 'whole systems' model proves effective and cost-effective, it will provide decision-makers with a model for the delivery of self-management support for populations with long-term conditions that can be implemented widely to maximise 'reach' across the wider patient population. Trial registration number ISRCTN: ISRCTN90940049