Friday, June 15, 2007

Giving Patients Control 'Won't Cut Costs'

Friday, 15th June 2007, 00:35

Giving patients more control over managing their illness will not reduce healthcare costs, according to new research.

The government's Expert Patient Programme offers courses to help people cope with their long term conditions and diseases.

These include arthritis, asthma, back pain, diabetes, heart conditions, multiple sclerosis, mental health issues and many others.

The scheme which has already cost £18 million has been heavily promoted as part of a drive to deliver NHS savings and will be rolled out to 100,000 patients by 2012.

But researchers say four trials in the UK suggest there is little evidence to date that they make an important impact on either hospital admissions or the use of other healthcare resources.

In 2001 the chief medical officer, Sir Liam Donaldson, concluded that self management programmes for chronic diseases would improve health status, slow the progression of disease, and reduce healthcare use, and that the NHS should invest heavily in the Expert Patient Programme.

But the researchers, whose findings are published in the British Medical Journal, say that although lay led programmes may increase patients' confidence to manage their disease, questions remain about their impact on health in patients.

Dr Stephanie Taylor, senior clinical lecturer at Queen Mary's School of Medicine and Dentistry, London, said lay led programmes in the UK need evaluation before they can be recommended over other programmes with established impact.

She said: "Considerable hyperbole has surrounded the UK expert patient programme, and some patients attending courses have given powerful personal accounts of their benefits.

"However, these accounts must now be seen in the context of the modest results of four well powered randomised trials in the UK.

"Although early results suggest that the programme can improve patients’ confidence, questions remain about its impact on health in patients in the UK."

The researchers also point out primary care trusts or general practice commissioning groups will need to consider carefully the costs of investing in this programme compared with other rehabilitation programmes for chronic disease.

The courses are designed to run alongside medical treatments, and benefits can include a reduction in symptoms, less pain, greater self confidence and a better quality of life.

The free programme is aimed at helping patients find information, develop problem solving skills, communicate with health professionals and cope with depression and their own pain management. It will be led by other people with long term conditions or experience of caring.

Volunteers will be recruited and given the opportunity to receive accredited training, to enable them to deliver self management courses to others in similar circumstances

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