Enhancing self-management in primary care for people experiencing socioeconomic deprivation with multiple long-term conditions

PI Title: Dr Megan Armstrong

Lead member: QMUL

Background
Long-term health conditions are health problems that require ongoing management and cannot be cured. In England, 43% of adults have these conditions, and they account for about 70% of health and social care funding. People facing socioeconomic deprivation (PESD) are more likely to have long-term health conditions, and these conditions tend to be more severe. Multiple Long-Term Conditions (MLTCs), where an individual has two or more long-term conditions, are on the rise, with PESD almost twice as likely to have MLTCs. Managing MLTCs is challenging because these conditions vary widely. It leads to increased healthcare use, hospitalisations, and social care costs. Self-management is key, involving medical support, changes in behaviour, and well-being. General practitioners (GPs) and other healthcare professionals (HCPs) play important roles in supporting self-management, but their views differ. A recent review found that PESD with MLTCs struggle to proactively self-manage due to a lack of money and support, and health information not making sense. PESD also reported feeling less able to talk with their doctors due to a fear of being judged.

Aims: To increase the use of self-management interventions and strategies for PESD with MLTCs in primary care to improve their quality of life and reduce the burden on primary care.

What will we do?
Part 1: Qualitative Study
• Who? We will interview up to 18 GPs, practice nurses, and pharmacists in deprived areas in East London and Sheffield.
• How? We will conduct interviews to explore barriers and facilitators of managing people with MLTCs, requirements for successful interventions, and barriers and solutions to implementation.
• So what? We will group common findings into ‘themes’ and these themes/findings will create recommendations for primary care policy changes and inform future research studies that use self-management.

Part 2: Taxonomy Development
• Identifying important aspects of self-management interventions for PESD: From previously conducted research studies, we will identify key aspects of interventions that help PESD take part and create a list of these aspects.
• Bringing the findings together: Extracted information will be grouped into key components to create a first draft ‘taxonomy’ (i.e., a list of common intervention aspects that other researchers or doctors could use).
• Refine the Taxonomy: Input from experts in the field will ensure the taxonomy is accurate and could be used in real life or in interventions.

Impact
This project aims to develop a taxonomy of techniques for PESD in self-management interventions and identify ways to overcome implementation barriers. This will lead to more effective approaches to managing MLTCs in a range of circumstances, benefiting both patients and healthcare services. It will contribute to improved health outcomes and quality of life for PESD. Future plans include developing interventions for primary care.

Amount awarded:  £49, 875