Effectiveness of personalised support for self-management in primary care: a cluster randomised controlled trial
Open accessAbstract
BACKGROUND: Self-management support is an important component of the clinical management of many chronic conditions. The validated Self-Management Screening questionnaire (SeMaS) assesses individual characteristics that influence a patient's ability to self-manage. AIM: To assess the effect of providing personalised self-management support in clinical practice on patients' activation and health-related behaviours. DESIGN AND SETTING: A cluster randomised controlled trial was conducted in 15 primary care group practices in the south of the Netherlands. METHOD: After attending a dedicated self-management support training session, practice nurses in the intervention arm discussed the results of SeMaS with the patient at baseline, and tailored the self-management support. Participants completed a 13-item Patient Activation Measure (PAM-13) and validated lifestyle questionnaires at baseline and after 6 months. Data, including individual care plans, referrals to self-management interventions, self-monitoring, and healthcare use, were extracted from patients' medical records. Multilevel multiple regression was used to assess the effect on outcomes. RESULTS: The PAM-13 score did not differ significantly between the control (n = 348) and intervention (n = 296) arms at 6 months. In the intervention arm, 29.4% of the patients performed self-monitoring, versus 15.2% in the control arm (effect size r = 0.9, P = 0.01). In the per protocol analysis (control n = 348; intervention n = 136), the effect of the intervention was significant on the number of individual care plans (effect size r = 1.3, P = 0.04) and on self-monitoring (effect size r = 1.0, P = 0.01). CONCLUSION: This study showed that discussing SeMaS and offering tailored support did not affect patient activation or lifestyle, but did stimulate patients to self-monitor and use individual care plans.
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Five studies reported on level of physical activity.
“Five studies reported on level of physical activity”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [59]
Seven RCTs reported non-significant improvements in self-efficacy.
“Seven RCTs reported non-significant improvements in self-efficacy”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [59]
Eikelenboom et al. reported no significant difference in PAM-13 scores between control and intervention arms at six-month follow-up.
“Eikelenboom et al. reported no significant difference in PAM-13 scores (measure of patient activation [132]) between control and intervention arms at six-month follow-up”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [59]
No significant between-group differences were reported for physical activity in 4 RCTs.
“No significant between group differences were reported for physical activity in 4 RCTs”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [59]
Cites
Sterne, J. A. C., White, I. R., Carlin, J. B., Spratt, M., Royston, P., Kenward, M. G., Wood, A. M., & Carpenter, J. R. (2009) · BMJ · doi:10.1136/bmj.b2393 · Cited by 7,299 · see citing works
Development and Testing of a Short Form of the Patient Activation Measure
Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005) · Health Services Research · doi:10.1111/j.1475-6773.2005.00438.x · Cited by 1,939 · see citing works
Brief questions to identify patients with inadequate health literacy.
Chew, L. D., Bradley, K. A., & Boyko, E. J. (2004) · PubMed · Cited by 1,920 · see citing works
Orrow, G., Kinmonth, A.-L., Sanderson, S., & Sutton, S. (2012) · BMJ · doi:10.1136/bmj.e1389 · Cited by 739 · see citing works
The Rapid Assessment of Physical Activity (RAPA) among older adults.
Topolski, T. D., LoGerfo, J. P., Patrick, D. L., Williams, B., Walwick, J., & Patrick, M. B. (2006) · Europe PMC (PubMed Central) · Cited by 661 · see citing works
Personalised care planning for adults with chronic or long-term health conditions
Coulter, A., Entwistle, V. A., Eccles, A., Ryan, S., Shepperd, S., & Perera, R. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010523.pub2 · Cited by 592 · see citing works
Self-management education for patients with chronic obstructive pulmonary disease
Effing, T., Monninkhof, E. E., van der Valk, P. P. D. L. P. M., Zielhuis, G. G., Walters, E. H., van der Palen, J. J., & Zwerink, M. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002990.pub2 · Cited by 536 · see citing works
Is Patient Activation Associated With Outcomes of Care for Adults With Chronic Conditions?
Mosen, D. M., Schmittdiel, J. A., Hibbard, J. H., Sobel, D. S., Remmers, C., & Bellows, J. (2007) · Journal of Ambulatory Care Management · doi:10.1097/00004479-200701000-00005 · Cited by 478 · see citing works
Applicability of Internationally Available Health Literacy Measures in the Netherlands
Fransen, M. P., van Schaik, T. M., Twickler, T. B., & Essink‐Bot, M. (2011) · Journal of Health Communication · doi:10.1080/10810730.2011.604383 · Cited by 244 · see citing works
Kennedy, A., Bower, P., Reeves, D., Blakeman, T., Bowen, R., Chew-Graham, C., Eden, M., Fullwood, C., Gaffney, H., Gardner, C., et al. (2013) · BMJ · doi:10.1136/bmj.f2882 · Cited by 239 · see citing works
Segal-Isaacson, C. J., Wylie‐Rosett, J., & Gans, K. M. (2004) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572170403000512 · Cited by 231 · see citing works
How can self-efficacy be increased? Meta-analysis of dietary interventions
Prestwich, A., Kellar, I., Parker, R. A., MacRae, S., Learmonth, M., Sykes‐Muskett, B., Taylor, N. J., & Castle, H. (2013) · Health Psychology Review · doi:10.1080/17437199.2013.813729 · Cited by 225 · see citing works
Trappenburg, J. C. A., Monninkhof, E. M., Bourbeau, J., Troosters, T., Schrijvers, G., Verheij, T. J., & Lammers, J. J. (2011) · Thorax · doi:10.1136/thoraxjnl-2011-200071 · Cited by 138 · see citing works
Bartlett, Y. K., Sheeran, P., & Hawley, M. (2013) · British Journal of Health Psychology · doi:10.1111/bjhp.12071 · Cited by 76 · see citing works
Self-Measurement and Self-Titration in HypertensionA Pilot Telemedicine Study
BOBRIE, G., POSTELVINAY, N., DELONCA, J., & CORVOL, P. (2007) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2007.08.011 · Cited by 68 · see citing works
Eikelenboom, N., Smeele, I. J. M., Faber, M. J., Jacobs, A., Verhulst, F. C., Lacroix, J. P. W., Wensing, M., & van Lieshout, J. (2015) · BMC Family Practice · doi:10.1186/s12875-015-0381-z · Cited by 63 · see citing works
Self-citationGranger, B. B., Ekman, I., Hernandez, A. F., Sawyer, T., Bowers, M., DeWald, T. A., Zhao, Y., Levy, J. A., & Bosworth, H. B. (2015) · American Heart Journal · doi:10.1016/j.ahj.2015.01.006 · Cited by 61 · see citing works
Lu, Z., Cao, S., Chai, Y., Liang, Y., Bachmann, M. O., Suhrcke, M., & Song, F. (2012) · BMC Health Services Research · doi:10.1186/1472-6963-12-216 · Cited by 45 · see citing works
Eikelenboom, N., van Lieshout, J., Wensing, M., Smeele, I., & Jacobs, A. E. (2013) · Trials · doi:10.1186/1745-6215-14-336 · Cited by 26 · see citing works
Self-citationMcAndrew, L. M., Napolitano, M. A., POGACH, L. M., Quigley, K. S., Shantz, K. L., Veur, S. S. V., & Foster, G. D. (2012) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721712449434 · Cited by 24 · see citing works
Yaroch, A. L., Nebeling, L. C., Thompson, F. E., Hurley, T. G., Hébert, J. R., Toobert, D. J., Resnicow, K., Greene, G. W., Williams, G. C., Elliot, D. L., et al. (2008) · Journal of Nutrition · doi:10.1093/jn/138.1.185s · Cited by 19 · see citing works
Internet-Based Self-management Plus Education Compared With Usual Care in Asthma: A Randomized Trial
van der Meer, V., Bakker, M. J., van den Hout, W. B., Rabe, K. F., Sterk, P. J., Kievit, J., Assendelft, W. J. J., Sont, J. K., & for the SMASHING (Self-Management in Asthma Supported by Hospitals, I. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-2-200907210-00008 · Cited by 6 · see citing works
van der Burgt, M., & Verhulst, F. C. (2009) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-313-7742-8 · Cited by 4 · see citing works
Self-citationvan der Burgt, M., & Verhulst, F. C. (2009) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-313-7742-8_10 · Cited by 2 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Dineen-Griffin, S., Garcia-Cardenas, V., Williams, K., & Benrimoj, S. I. (2019) · PLoS ONE · doi:10.1371/journal.pone.0220116 · Cited by 600 · see citing works
“Eligible studies were randomized controlled trials (RCTs) and clusterrandomized controlled trials (c-RCTs) assessing SMS interventions with follow-up, delivered by primary HCPs, face-to-face to adult patients with any condition, compared to usual standard of care.”
BackgroundInfluentialCross, A. J., Elliott, R. A., Petrie, K., Kuruvilla, L., & George, J. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012419.pub2 · Cited by 269 · see citing works
A systematic review and meta-analysis of patient activation in people living with chronic conditions
Cuevas, H. E., Heitkemper, E., Huang, Y., Jang, D. E., García, A. A., & Zuniga, J. A. (2021) · Patient Education and Counseling · doi:10.1016/j.pec.2021.02.016 · Cited by 53 · see citing works
Poureslami, I. M., FitzGerald, J. M., Tregobov, N., Goldstein, R. S., Lougheed, M. D., & Gupta, S. (2022) · Respiratory Research · doi:10.1186/s12931-022-02290-5 · Cited by 52 · see citing works
Person-centered diabetes care and patient activation in people with type 2 diabetes
Rutten, G. E. H. M., van Vugt, H. A., & de Koning, E. J. P. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2020-001926 · Cited by 49 · see citing works
Rochfort, A., Beirne, S., Doran, G., Patton, P., Gensichen, J., Kunnamo, I., Smith, S. M., Eriksson, T., & Collins, C. (2018) · BMC Family Practice · doi:10.1186/s12875-018-0847-x · Cited by 45 · see citing works
eHealth for people with COPD in the Netherlands: a scoping review
Hallensleben, C., van Luenen, S., Rolink, E., Ossebaard, H. C., & Chavannes, N. H. (2019) · International Journal of COPD · doi:10.2147/copd.s207187 · Cited by 43 · see citing works
Shnaigat, M., Downie, S., & Hosseinzadeh, H. (2021) · COPD · doi:10.1080/15412555.2021.1872061 · Cited by 36 · see citing works
Yadav, U. N., Hosseinzadeh, H., & Baral, K. (2017) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2017.10.004 · Cited by 33 · see citing works
Hosseinzadeh, H., Downie, S. R., & Shnaigat, M. (2022) · Australian Journal of Primary Health · doi:10.1071/py21176 · Cited by 39 · see citing works
Rutten, G. E. H. M., van Vugt, H. A., de Weerdt, I., & de Koning, E. J. P. (2018) · Diabetes Care · doi:10.2337/dc17-1194 · Cited by 33 · see citing works
Shnaigat, M., Downie, S., & Hosseinzadeh, H. (2022) · The Australian journal of rural health · doi:10.1111/ajr.12828 · Cited by 27 · see citing works
Menichetti, J., Graffigna, G., & Steinsbekk, A. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.12.009 · Cited by 32 · see citing works
Generic Self-Reported Questionnaires Measuring Self-Management: A Scoping Review
Hudon, É., Hudon, C., Lambert, M., Bisson, M., & Chouinard, M. (2020) · Clinical Nursing Research · doi:10.1177/1054773820974149 · Cited by 30 · see citing works
Gray, C. S., Chau, E., Tahsin, F., Harvey, S., Loganathan, M., McKinstry, B., Mercer, S. W., Nie, J. X., Palen, T. E., Ramsay, T., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/29071 · Cited by 27 · see citing works
Skovlund, S. E., Troelsen, L. H., Nørgaard, L. M., Pietraszek, A., Jakobsen, P. E., & Ejskjær, N. (2021) · JMIR Formative Research · doi:10.2196/28329 · Cited by 20 · see citing works
Patient Activation for Self-Management in Patients with Idiopathic Pulmonary Fibrosis or Sarcoidosis
Bloem, A. E. M., Mostard, R., Stoot, N., Custers, J., Vooijs, M., Janssen, D., Hul, A. V. V. '., & Spruit, M. (2021) · Respiration · doi:10.1159/000518216 · Cited by 13 · see citing works
Collins, C., Doran, G., Patton, P., Fitzgerald, R., & Rochfort, A. (2021) · BJGP Open · doi:10.3399/bjgpo.2020.0186 · Cited by 16 · see citing works
Peters, J. B., Antons, J. C., Koolen, N., van Helvoort, H. A. C., van Hees, H. W. H., van den Borst, B., Spruit, M. A., Vercoulen, J. H. M. M., & Hul, A. J. V. ‘. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.947402 · Cited by 16 · see citing works
Healey, E. L., Lewis, M., Shivji, N. A., van der Windt, D., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2023) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-023-06452-4 · Cited by 11 · see citing works
Babatunde, O. O., Shivji, N. A., Rowlands, G., Quicke, J. G., Healey, E. L., Protheroe, J., & van der Windt, D. (2023) · Health Open Research · doi:10.12688/healthopenres.13151.1 · Cited by 8 · see citing works
Pulmonary Rehabilitation Improves Self-Management Ability in Subjects With Obstructive Lung Disease
Janssen, S. M. J., Vlieland, T. P. M. V., Volker, G., Spruit, M. A., & Abbink, J. J. (2021) · Respiratory Care · doi:10.4187/respcare.07852 · Cited by 9 · see citing works
Heijmans, N., van Lieshout, J., & Wensing, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0185341 · Cited by 7 · see citing works
Self-citationPAM-13 in Clinical Cancer Care: A Systematic Review
Pierre, K. J., Vérot, E., & Bouleftour, W. (2024) · Archives of Medical Research · doi:10.1016/j.arcmed.2024.103145 · Cited by 7 · see citing works
Kendall, C., Shoemaker, E. S., Crowe, L., MacPherson, P. A., Becker, M., Levreault, E., Boucher, L. M., Rosenes, R., Bibeau, C., Lundrigan, P., et al. (2018) · AIDS Care · doi:10.1080/09540121.2018.1469723 · Cited by 7 · see citing works
Öberg, U., Orre, C. J., Hörnsten, Å., Jutterström, L., & Isaksson, U. (2020) · JMIR Nursing · doi:10.2196/16318 · Cited by 6 · see citing works
Corbett, C. F., Daratha, K. B., McPherson, S., Smith, C. L., Wiser, M. S., Vogrig, B. K., Murphy, S. M., Cantu, R., & Dyck, D. G. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115690 · Cited by 5 · see citing works
Al‐Yateem, N., Fakhry, R., Saifan, A. R., Saqan, R., & Alrimawi, I. (2021) · Journal of Nursing Management · doi:10.1111/jonm.13517 · Cited by 5 · see citing works
Vos, R. C., Eikelenboom, N., Klomp, M. L. H., Stellato, R. K., & Rutten, G. E. H. M. (2016) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-016-0199-4 · Cited by 5 · see citing works
Self-citationGregory, E. F., Wright, C., Matone, M., Rubin, D. M., & Lorch, S. A. (2018) · Global Pediatric Health · doi:10.1177/2333794x18765368 · Cited by 3 · see citing works
Pathak, N., Newham, R., Smith, N. A., & Burgess, R. (2025) · Musculoskeletal Care · doi:10.1002/msc.70075 · Cited by 1 · see citing works
Rohilla, U., Ramarao, J., Lane, J., Khatri, N. N., Smith, J. A., Yin, K., & Lau, A. Y. S. (2023) · Digital Health · doi:10.1177/20552076231176162 · Cited by 1 · see citing works
Co-commissioning at the Micro-Level: Personalised Budgets in Health and Social Care
Musekiwa, E., & Needham, C. E. (2020) · Springer eBooks · doi:10.1007/978-3-030-53705-0_13 · Cited by 1 · see citing works
Healey, E. L., Lewis, M., Nadia Corp, Shivji, N. A., Windt, D., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2024) · Figshare · doi:10.6084/m9.figshare.26596238
Healey, E. L., Lewis, M., Nadia Corp, Shivji, N. A., Windt, D., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2024) · Figshare · doi:10.6084/m9.figshare.26596241
Healey, E. L., Lewis, M., Nadia Corp, Shivji, N. A., Windt, D., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2024) · Figshare · doi:10.6084/m9.figshare.26596247
Healey, E. L., Lewis, M., Nadia Corp, Shivji, N. A., Windt, D., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2024) · Figshare · doi:10.6084/m9.figshare.26596235
Healey, E. L., Lewis, M., Nadia Corp, Shivji, N. A., Windt, D., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2024) · Figshare · doi:10.6084/m9.figshare.26596244
Healey, E. L., Lewis, M., Nadia Corp, Shivji, N. A., Windt, D., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2024) · Figshare · doi:10.6084/m9.figshare.26596232
Healey, E. L., Lewis, M., Nadia Corp, Shivji, N. A., Windt, D., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2024) · Figshare · doi:10.6084/m9.figshare.26596229
Healey, E. L., Lewis, M., Nadia Corp, Shivji, N. A., van der Windt, D. A., Babatunde, O. O., Simkins, J., Bartlam, B., Rowlands, G., & Protheroe, J. (2024) · Figshare · doi:10.6084/m9.figshare.26596226
Self-management barriers in dialysis patients: a target for improving health outcomes
Driehuis, E., Meuleman, Y., Hobo, S. G. D., Bonenkamp, A. A., Dekker, F. W., Abrahams, A. C., van Jaarsveld, B. C., of the DOMESTICO study group, Leurs, P. B., van der Net, J. B., et al. (2026) · Journal of Nephrology · doi:10.1093/joneph/aajag191
- Authors
- Eikelenboom, N., van Lieshout, J., Jacobs, A., Verhulst, F., Lacroix, J., van Halteren, A., Klomp, M., Smeele, I., & Wensing, M.
- Affiliations
- Radboud University Medical Center (NL)
- Venue
- British Journal of General Practice
- Published
- 2016-04-14
- Volume
- 66
- Issue
- 646
- Pages
- e354-e361
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC4838448
- OpenAlex
- W2340542514
- Cited by
- 42
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 9 · 2023: 3 · 2022: 4 · 2021: 9 · 2020: 5 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 1
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- self-management support, individualized support, chronic disease, patient activation, Patient Activation Measure, self-monitoring, individualized care plans, practice nurses, lifestyle habits, primary care, health care utilization
- MeSH terms
- Chronic Disease, Clinical Protocols, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Netherlands, Primary Health Care, Surveys and Questionnaires, Self Care, Social Support, Health Behavior, Risk Reduction Behavior, Precision Medicine
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