Treatment costs fall and quality improves when patients use self-treatment tools

Encouraging patients to become involved in providing their own care can reduce the cost and improve the quality of long-term medical treatment, say researchers from Massachusetts General Hospital and Massachusetts Institute of Technology in PLoS Medicine this week.

Harold DeMonaco and Eric von Hippel say that there is now a body of research to support their assertion. "Such studies found that self-management produced higher quality outcomes at lower costs than conventional models of care," they say.

The authors define self-management as:

• engaging in activities that protect and promote health
• monitoring and managing symptoms and signs of illness
• managing the impacts of illness on function, emotions, and interpersonal relationships; and
• adhering to treatment regimens.

Examples of such self-management tools are those that allow patients with diabetes to calculate the correct dose of insulin and then inject it themselves, and tools that allow people with heart failure or depression to adjust the dosage of their medicines themselves based on their symptoms.

In their essay, the authors consider the advantages and limitations of self-management tools and consider why these tools have not become more widespread in medical practice.

"We propose that the time has come," they say, "for health systems to support appropriate and appropriately timed shifts from practitioner-based care to patient self-management."

http://www.plos.org