Abstract
BackgroundIn response to the escalating burden of chronic illness in Australia, recent health policies have emphasised the promotion of patient self-management and better preventive care. A notable omission from these policies is the acknowledgment that patients with chronic illness tend to have co-morbid conditions. Our objectives were: to identify the common challenges co-morbidity poses to patients and carers in their experiences of self-management; to detail the views and perceptions of health professionals about these challenges; and to discuss policy options to improve health care for people with co-morbid chronic illness. The method included semi-structured interviews and focus groups with 129 purposively sampled participants. Participants were people with Type 2 diabetes, chronic obstructive pulmonary disease and/or chronic heart failure as well as carers and health care professionals. Content analysis of the interview data was conducted using NVivo7 software.ResultsPatients and their carers found co-morbidity influenced their capacity to manage chronic illness in three ways. First, co-morbidity created barriers to patients acting on risk factors; second, it complicated the process of recognising the early symptoms of deterioration of each condition, and third, it complicated their capacity to manage medication.ConclusionFindings highlight challenges that patients with multiple chronic conditions face in relation to preventive care and self-management. Future clinical policy initiatives need to move away from single illness orientation toward strategies that meet the needs of people with co-morbid conditions and strengthen their capacity to self-manage. These patients will benefit directly from specialised education and services that cater to the needs of people with clusters of co-morbidities.
Highlights
In response to the escalating burden of chronic illness in Australia, recent health policies have emphasised the promotion of patient self-management and better preventive care
In response to the escalating burden of chronic illness in Australia, the Council of Australian Governments instigated the Better Health for All Initiative [1] in line with the 2005 National Chronic Disease Strategy [2]. Central to these changes is the promotion of patient self-management and better preventive care through increased patient support to act on risk factors [3,4]
Patients and carers were recruited through referrals from general practices, local hospitals, community health services, specialist clinics, health care consumer organisations, as well as Aboriginal health services located in the Australian Capital Territory (ACT) and western suburbs of Sydney in Australia
Summary
In response to the escalating burden of chronic illness in Australia, recent health policies have emphasised the promotion of patient self-management and better preventive care. In response to the escalating burden of chronic illness in Australia, the Council of Australian Governments instigated the Better Health for All Initiative [1] in line with the 2005 National Chronic Disease Strategy [2]. Central to these changes is the promotion of patient self-management and better preventive care through increased patient support to act on risk factors [3,4].
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