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Research project: Whole System Informing Self-management Engagement (WISE)

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Evidence shows that there are difficulties in engaging existing community-based self-care support programmes with primary care ; and there are questions about how effective such programmes (set in isolation from care providers) are in improving outcomes for people with long-term conditions Whole System Informing Self-management Engagement (WISE) encompasses an approach to finding and providing appropriate self-care support for people with long-term conditions which

  • Links peoples’ self-defined needs, abilities and values to the management of their condition;
  • Engages health professionals in giving self care support through training;
  • Making self- care support fit closely to the resources and organisations of the health care system, locality and community.

The rationale and the evidence base for the WISE approach has been developed over the last 15 years (Kennedy & Rogers Kennedy Rogers Bower 2007 (see key publications). The whole systems approach resonates both with a co-production view of patient involvement and the Chronic Care Model proposed by Wagner, to ensure self-care support is considered using a collaborative approach orientated to delivery .

The approach being tested out in this research envisages enabling patients by providing opportunities for receiving and using more patient friendly information combined with support and guidance from trained practitioners working within a healthcare system more equipped and expecting to be responsive to patients' needs. The key principles incorporate the need to be able to: work for patients and professionals, and fit with the organisation of the healthcare system. This includes the different ways patients currently self-manage; build on existing skills of patients and professionals; and make certain people from underserved groups are included.

The present study aims to refine the patient, practitioner, and patient level components of the WISE approach and translate the principles of WISE into an operational intervention deliverable through National Health Service training methods. It has been rolled out across a whole PCT and is being evaluated by a cluster randomised controlled trial investigating the outcomes and costs of the WISE approach in primary care and a process evaluation. Trial outcomes are at patient level and although the training is generic, some of the resources have been specifically developed for people with diabetes, COPD or IBS. The objective of the process evaluation is to use normalisation process model principles to answer the question ‘How is the new initiative translated and implemented in practice?’ A number of qualitative and quantitative methods are being used :

Completion Summer 2013

Project Funders include:

  • National Institute of Health Research Programme GrantRP-PG-0407-10136
    Evaluating and implementing better patient-orientated management of chronic gastrointestinal disorders in primary care. 2008-2013
  • National Primary Care Research and Development Centre (Department of Health) 2007- 2010

Principle Investigator: Dr Anne Kennedy, Senior Research Fellow, Health Sciences University of Southampton ( )

Co- Investigators: Professor Anne Rogers, Health Sciences, University of Southampton)

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