The Critical Role of Care Managers in Facilitating Successful Self-Management among Patients with Chronic Illnesses

• In Event: 3129 - Section on Medical Sociology Refereed Roundtables (1 hour)
  In Refereed Roundtable 60min: Table 16. Social Relationships and Health

Abstract

Aims and Objectives: This study investigates care managers’ role in facilitating positive self-management behaviors among patients with chronic conditions.
Background: Care managers have a growing role in self-management programs. Several models targeted at patients with chronic conditions have a care manager integrated to facilitate care, motivate behavioral change, and coach about self–management. The mechanisms of potential enhancement to self-management by care managers are not known and needed to strengthen their efficacy.
Methods: We interviewed and observed 18 patients and 10 providers in a single internal medicine clinic who worked with and did not work with care managers. Providers’ responses to a short survey provided contextual information to understand the environment in which the observations occurred. The qualitative data consisted of transcribed observations during patient-provider office and semi-structured interviews with patients. Using grounded theory, multiple researchers independently and then collaboratively coded the qualitative data to identify themes focused on capturing patients self-management understanding and behaviors.
Results: Patients described four areas where care managers may promote positive self-management activities: information resources, caring relationships, direct self-management/motivation, and support networks.
Conclusion: Patients' general experience with self-management seemed to revolve around the four themes identified. Patients working with care mangers had qualitative differences in the aspects of these themes. Care managers were seen as a catalyst towards self-management among patients with chronic conditions by informing, motivating, caring, and supporting patients. Further research is needed to investigate how care managers can be effectively integrated within clinical teams to promote patient self-management activities.
Relevance to Clinical Practice: In light of current efforts to re-design our health care system to better meet the needs of the growing number of patients with chronic conditions, utilizing care managers or other health professionals may promote partnership-based collaboration improvement in self-management.

Author

• Cirila Estela Vasquez Guzman, Center on Budget and Policy Priorities