NDLI: Care plans and care planning in the management of long-term conditions in the UK: a controlled prospective cohort study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Reeves, David Hann, Mark Rick, Jo Rowe, Kelly Small, Nicola Burt, Jenni Roland, Martin Protheroe, Joanne Blakeman, Tom Richardson, Gerry Kennedy, Anne Bower, Peter
Description	Author Affiliation: Reeves D ( NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester.); Hann M ( NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester.); Rick J ( NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester.); Rowe K ( NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester.); Small N ( NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester.); Burt J ( Department of Public Health and Primary Care, University of Cambridge, Cambridge.); Roland M ( Department of Public Health and Primary Care, University of Cambridge, Cambridge.); Protheroe J ( Institute of Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, Keele.); Blakeman T ( NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester.); Richardson G ( Centre for Health Economics, University of York, York.); Kennedy A ( Faculty of Health Sciences, University of Southampton, Southampton.); Bower P ( NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester.)
Abstract	BACKGROUND: In the UK, the use of care planning and written care plans has been proposed to improve the management of long-term conditions, yet there is limited evidence concerning their uptake and benefits. AIM: To explore the implementation of care plans and care planning in the UK and associations with the process and outcome of care. DESIGN AND SETTING: A controlled prospective cohort study among two groups of patients with long-term conditions who were similar in demographic and clinical characteristics, but who were registered with general practices varying in their implementation of care plans and care planning. METHOD: Implementation of care plans and care planning in general practice was assessed using the 2009-2010 GP Patient Survey, and relationships with patient outcomes (self-management and vitality) were examined using multilevel, mixed effects linear regression modelling. RESULTS: The study recruited 38 practices and 2439 patients. Practices in the two groups (high and low users of written documents) were similar in structural and population characteristics. Patients in the two groups of practices were similar in demographics and baseline health. Patients did demonstrate significant differences in reported experiences of care planning, although the differences were modest. Very few patients in the cohort reported a written plan that could be confirmed. Analysis of outcomes suggested that most patients show limited change over time in vitality and self-management. Variation in the use of care plans at the practice level was very limited and not related to patient outcomes over time. CONCLUSION: The use of written care plans in patients with long-term conditions is uncommon and unlikely to explain a substantive amount of variation in the process and outcome of care. More proactive efforts at implementation may be required to provide a rigorous test of the potential of care plans and care planning.
File Format	HTM / HTML
ISSN	09601643
e-ISSN	14785242
DOI	10.3399/bjgp14X681385
Journal	British Journal of General Practice
Issue Number	626
Volume Number	64
Language	English
Publisher	Royal College of General Practitioners
Publisher Date	2014-09-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Therapy Research Support, Non-u.s. Gov't Prospective Studies Discipline Family Medicine Attitude Of Health Personnel Epidemiology Patient Satisfaction Organization & Administration Patient Care Planning Physician-patient Relations Primary Health Care Statistics & Numerical Data Health Policy Chronic Disease Health Care Surveys
Content Type	Text
Resource Type	Article
Subject	Family Practice

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