Trial reportBMJ (Clinical research ed.)2013
Implementation of self management support for long term conditions in routine primary care settings: cluster randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 131 papers, 28 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
131 citing papers in PubMed, 28 syntheses or guidelines pooled it.
- Identifying the active components through the behaviour change techniques taxonomy in complex interventions for people living with multiple long-term health conditions: A systematic review.British journal of health psychology · 2025Pooled it
- Effectiveness of self-management interventions for long-term conditions in people experiencing socio-economic deprivation in high-income countries: a systematic review and meta-analysis.Journal of public health (Oxford, England) · 2023Pooled it
- Efficacy of sustained knowledge translation (KT) interventions in chronic disease management in older adults: systematic review and meta-analysis of complex interventions.BMC medicine · 2023Pooled it
- Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care.The Cochrane database of systematic reviews · 2022Pooled it
- Self-management interventions for people with chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2022Pooled it
- Integrated disease management interventions for patients with chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2021Pooled it
- Digital interventions for the management of chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2021Pooled it
- Interventions for improving outcomes in patients with multimorbidity in primary care and community settings.The Cochrane database of systematic reviews · 2021Pooled it
- Pooled it
- Interventions for involving older patients with multi-morbidity in decision-making during primary care consultations.The Cochrane database of systematic reviews · 2019Pooled it
- Underlying mechanisms of complex interventions addressing the care of older adults with multimorbidity: a realist review.BMJ open · 2019Pooled it
- Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice.PloS one · 2019Pooled it
- Systematic review of the effectiveness of community-based self-management interventions among primary care COPD patients.NPJ primary care respiratory medicine · 2018Pooled it
- Effects of Self-Management Interventions in Patients With Irritable Bowel Syndrome: Systematic Review.Western journal of nursing research · 2018Pooled it
- Interventions for increasing the use of shared decision making by healthcare professionals.The Cochrane database of systematic reviews · 2018Pooled it
- Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review.Implementation science : IS · 2018Pooled it
- Self-management for bronchiectasis.The Cochrane database of systematic reviews · 2018Pooled it
- Systematic review of self-management interventions for people with eczema.The British journal of dermatology · 2017Pooled it
- Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2017Pooled it
- Correlates of quality of life among individuals with epilepsy enrolled in self-management research: From the US Centers for Disease Control and Prevention Managing Epilepsy Well Network.Epilepsy & behavior : E&B · 2017Pooled it
71 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
objectiveTo determine the effectiveness of an intervention to enhance self management support for patients with chronic conditions in UK primary care.
designPragmatic, two arm, cluster randomised controlled trial.
settingGeneral practices, serving a population in northwest England with high levels of deprivation.
participants5599 patients with a diagnosis of diabetes (n=2546), chronic obstructive pulmonary disease (n=1634), and irritable bowel syndrome (n=1419) from 43 practices (19 intervention and 22 control practices).
interventionPractice level training in a whole systems approach to self management support. Practices were trained to use a range of resources: a tool to assess the support needs of patients, guidebooks on self management, and a web based directory of local self management resources. Training facilitators were employed by the health management organisation.
main outcome measuresPrimary outcomes were shared decision making, self efficacy, and generic health related quality of life measured at 12 months. Secondary outcomes were general health, social or role limitations, energy and vitality, psychological wellbeing, self care activity, and enablement.
resultsWe randomised 44 practices and recruited 5599 patients, representing 43% of the eligible population on the practice lists. 4533 patients (81.0%) completed the six month follow-up and 4076 (72.8%) the 12 month follow-up. No statistically significant differences were found between patients attending trained practices and those attending control practices on any of the primary or secondary outcomes. All effect size estimates were well below the prespecified threshold of clinically important difference.
conclusionsAn intervention to enhance self management support in routine primary care did not add noticeable value to existing care for long term conditions. The active components required for effective self management support need to be better understood, both within primary care and in patients' everyday lives.
trial registrationCurrent Controlled Trials ISRCTN90940049.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.