The Case for Self Management: An Arthritis Ireland Report on Seven Years of Positive Patient Outcomes
The health of the Irish people and its health system are facing a significant challenge from the rising tide of chronic conditions such as arthritis, diabetes and heart disease. The consequence of a number of factors including an ageing population and increasing obesity levels, already 1 in 3 people are living with a chronic illness in Ireland and this proportion will continue to grow in the years ahead.
Despite great advancements in medications in recent decades, the healthcare system has come under unprecedented strain as it saddles the burden of major budgetary cutbacks coupled with this growing pandemic. Taking arthritis as an example, high-tech biologic treatments have been extremely effective in stopping joint damage in its tracks but - as no cure exists - patients still need to manage their own condition outside of the clinical setting and the impact it has on their lives such as pain, fatigue, social isolation and loss of employment.
This is where the Arthritis Self Management Programme -- delivered nationwide by Arthritis Ireland over the last 7 years - makes a big difference. By complementing clinical treatment with education and training in problem solving and action planning, it enables and empowers patients to live happier, healthier lives.
The evidence demonstrating the efficacy of this initiative is resounding both nationally and internationally. In a 3 year evaluation of the Arthritis Ireland course (Living Well with Arthritis) - comprising 3,500 participants put through 200 courses - the results show a significant improvement in ability to cope with pain, fatigue and general ability to live with the condition. Furthermore, there is conclusive evidence to demonstrate that this programme reduces healthcare utilisation, including visits to GPs and hospitals. According to one study conducted in the USA, taking $1,000 as an average cost per hospital day and $100 for an average cost of ED visit, the expected savings would be $990 per course participant in the first year.
There is no doubt that self management does work but in order to tackle rising levels of chronic illness, its true potential must be realised. The following key recommendations require implementation if this is to occur:
Recognise that self-management programmes are a core clinical priority for all chronic diseases
Provide education and training to clinicians and healthcare professionals so that they develop a comprehensive understanding of the self management ethos and can promote it among their patients
Recognise the vital role the voluntary sector plays in delivering self-management programmes in a community setting.
