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Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - CoSMaS (Developing an interdisciplinary Collaborative Self-Management Support model: behavioural and communication tools for integrated care)

Teaser

Summary

Managing chronic health conditions is an increasing challenge to healthcare systems worldwide, especially in the context of an aging population, and requires urgent improvement of current healthcare models. Integrated care and patient empowerment represent promising solutions: offering tailored support for self-management in a collaborative framework already brought good results in several health care contexts. Yet, their large-scale implementation is still to be achieved. One limitation is the insufficient use of behavioural and communication research in healthcare improvement, to understand the social dynamics of collaborative management in routine care and the combined effects of the actions of multiple actors involved in self-management support. A second limitation is the lack of involvement of all stakeholders in the development of solutions for health service improvement, which led to a weak adoption and long-term sustainability of these programmes in routine care.
The CoSMaS project aimed to develop and test an interdisciplinary Collaborative Self- Management Support Model (CoSMaS) in several chronic conditions, together with related measurement tools, by taking into account the dynamics of collaborative care and using a participative approach to applied research

Work performed

The project has achieved substantial progress towards these ambitious goals, has ensured continuity of this initiative in several directions, and has enriched the initial objectives with several related studies and collaborations. Among the most notable of these achievements is the constitution of a qualitative corpus on stakeholder representations of collaborative self-management support in breast cancer, asthma and stroke, currently at analysis and dissemination stage. In addition, a systematic review of theoretical models of collaborative care in self-management support is ongoing as of May 2019. Two other related studies have already led to three peer-reviewed publications, have complemented the theoretical work with more applied research, and generated further projects. The remaining stages of the project, concerning model consensus and measurement tool development and testing, will be pursued with new funding.

Final results

Improving chronic care is a priority in the EU and worldwide, and requires common solutions adaptable to different chronic conditions. CoSMaS addressed these priorities by working towards developing a theoretical framework with direct relevance to routine care in France in several health conditions, and likely adaptable to other countries and to chronic care at large. Importantly, it worked with patients and health care professionals to identify priorities for collaborative care and self-management support in the Rhone-Alpes area, which represent a solid basis for local service improvement initiatives. By focusing on collaborative care, the resulting CoSMaS model has the potential to reduce costs due to care gaps or overlapping roles, and thus reduce both negative health outcomes and healthcare utilisation once interventions are implemented. This work will be pursued further in several collaborative projects for which funding has been acquired or is currently in review.