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Randomized Controlled Trial
. 2012 Jan 26:7:7.
doi: 10.1186/1748-5908-7-7.

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

Peter Bower  1 , 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, David Thompson
Affiliations
Randomized Controlled Trial

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

Peter Bower et al. Implement Sci. .

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.

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Figures

Figure 1
Figure 1
Study flowchart (original design-see discussion).
Figure 2
Figure 2
Outline of the WISE whole systems model.
Figure 3
Figure 3
Process of care in the WISE model.
Figure 4
Figure 4
Collaborative tasks, knowledge, attitudes, skills and support tools in WISE.
Figure 5
Figure 5
Training sessions.
Figure 6
Figure 6
CONSORT diagrams (baseline data only).
See this image and copyright information in PMC

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