A research study carried out in GP practices in England has found that it can be difficult to use self-management support tools in primary care. GP practices may not be prioritising, auditing or incentivising shared decisions and lifestyle change discussions.
A randomised trial in England found that training general practice staff to support self-management did not improve patient outcomes. This study assessed why self-management support failed to become part of usual practice. Twelve nursing staff from 12 practices were interviewed about using guidebooks for patients and shared decision-making tools three to six months after staff received training. The guidebooks were embedded in daily practice but shared decision-making tools were not. Nurses reported that this was because they believed the guidebooks improved patient-centred care and were not disruptive. Nurses were reluctant to engage with behaviour change discussions and self-management support was not seen as a priority in the practices. Support was not measured and was considered disruptive and time-consuming.
Kennedy A, Rogers A, Bowen R, Lee V, Blakeman T, Gardner C, et al. Implementing, embedding and integrating self-management support tools for people with long-term conditions in primary care nursing: a qualitative study. International Journal of Nursing Studies. 2014 Aug;51(8):1103-1113.