Helping Patients Manage Their Chronic Conditions

Thomas Bodenheimer, M.D., Kate MacGregor, M.P.H., and Claire Shafiri

This report describes five interlocking strategies that help clinicians and caregivers work with patients to help them manage their own chronic conditions. It also reviews literature describing the effectiveness of self-management support methods.

June 2005

Self-management support is the assistance caregivers give patients to encourage daily decisions that improve health-related behaviors and clinical outcomes. Self-management support includes a portfolio of techniques and tools that help patients choose healthy behaviors. But it also encompasses a fundamental transformation of the patient-caregiver relationship into a collaborative partnership.

This report describes five interlocking strategies that help caregivers work successfully within the collaborative model. It also reviews literature describing the effectiveness of self-management support methods.

Successful and appropriate self-management support is a challenge for primary care practices, the report concludes. Development of a collaborative team that includes non-physician caregivers working with physicians — combined with care innovations such as group settings and the use of interactive phone messaging systems, personal digital assistants (PDAs), and Web-based software — may aid in successful chronic disease self-management.

The full report is available under Document Downloads. Two related reports on tools and techniques for implementing patient self-management support are also provided.