Patient perceptions of clinician self-management support for chronic conditions.

OBJECTIVES

This study investigates the extent to which patients with chronic conditions perceive that they are receiving clinician self-management support for their conditions, and whether this perceived support is associated with self-management behaviors, such as exercise and taking medications for chronic conditions.

STUDY DESIGN

A survey of a representative sample of current and retired autoworkers and their spouses, all younger than 65 years, who are or were employed by the 3 major US automobile manufacturing companies.

METHODS

An index of self-management support was constructed from 3 survey questions that asked respondents with chronic conditions about their perceived level of self-management support from clinicians. Multivariate regression analysis examined: a) the extent to which perceived self-management support was influenced by patient engagement and other patient factors, and b) whether self-management support and patient engagement were associated with self-management behaviors, including exercise, use of certain preventive care services, and taking medications for specific chronic conditions.

RESULTS

Most patients with chronic conditions reported that their clinicians provide some degree of self-management support of their chronic conditions. The extent to which a patient is engaged with their medical care-such as taking notes or bringing along friends or relatives to ask questions-is strongly associated with perceptions that they receive self-management support from their clinicians. Receiving clinician self-management support was modestly associated with most self-management behaviors.

CONCLUSIONS

Receiving self-management support from clinicians can positively influence patient self-management of chronic conditions, but patient engagement with their own healthcare is crucial to whether patients perceive they are receiving such support. Moreover, while patient engagement may influence whether self-management support is given, the study results suggest that self-management support may be just as effective with patients who are less engaged with their healthcare.