Citation: Coulter A, Entwistle VA, Eccles A, Ryan S, Shepperd S, Perera R. Personalised care planning for adults with chronic or long-term health conditions. Cochrane Database of Systematic Reviews 2015, Issue 3. Art. No.: CD010523. DOI: 10.1002/14651858.CD010523.pub2.
People with long-term health conditions play an important part in managing their own health. But some of the tasks involved can be complicated, and require confidence and skill. Such tasks include taking medicines properly, monitoring symptoms, adopting or maintaining healthy lifestyles, managing their emotions, solving practical problems, knowing when and how to seek medical advice or community support, and coping with the impact of the condition(s) on their daily lives. Personalised care planning aims to provide support from health professionals that is tailored to the needs of individual patients. Such support recognises patients’ concerns, and helps them become more able to manage their own health. Personalised care planning is a conversation, or series of conversations, between a patient and a clinician when they jointly agree on goals and actions for managing the patient's health problems.
We carried out this systematic review to find out whether a personalised approach, in which patients are encouraged to participate in setting goals and action plans and determining their support needs, leads to better outcomes than when these decisions are taken by health professionals alone.
We found 19 randomised trials published before July 2013 that addressed this issue, involving 10,856 participants with conditions such as diabetes, mental health problems, heart failure, kidney disease, and asthma. The studies looked at a range of different interventions designed to involve patients and support self management. We combined and summarised results from studies that measured similar outcomes and found that involvement in personalised care planning probably led to small improvements in some indicators of physical health (better blood glucose levels, lower blood pressure measurements among people with diabetes, and control of asthma). It also probably reduced symptoms of depression, and improved people's confidence and skills to manage their health. We observed no effect on cholesterol, body mass index or quality of life. We found no evidence of any harms arising from personalised care planning. We found that the process worked best when it included preparation, record-sharing, care co-ordination and review, involved more intensive support from health professionals, and was integrated into routine care. However, the quality of evidence was only moderate, meaning that further research might change these findings.
We concluded that personalised care planning is a promising approach that offers the potential to provide effective help to patients, leading to better health outcomes. More research is needed to work out which aspects are most effective for specific patient groups.
For more information, see the full review on the Cochrane Library (http://bit.ly/18SbG0S) or contact the Consumers and Communication Review Group.