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Appendix 2. Research Questions and Needs

Patient Self-Management Support Programs: An Evaluation

Subject areasResearch questions and needs
Patient identification and triageWhat are the best methods for identifying patients who could benefit from self-management support programs?
What are the best methods for identifying those patients who are most amenable to making changes?
How can administrative data be used more precisely and quickly in patient identification?
What is the profile of patients who will get the biggest benefit and return from using monitoring devices?
What are the accuracy, utility, and impact of different severity stratification methods?
Patient outreachWhat incentives are most effective in getting people to participate and change their behavior?
What are the best methods for reaching and engaging patients identified as eligible for self-management support?
What are the characteristics of people who naturally try to behave in health-promoting ways? Can knowledge of these characteristics be used to engage people who do not naturally behave in health-promoting ways?
Does the speed of a program's patient engagement independently predict program success in a short time period?
Protocols for providing self-management supportWhat programming protocols are most effective in getting people to self-manage?
What are the best methods for motivating and supporting patients?
Can qualitative research help us better understand the interaction between support providers and patients and the various aspects of such interaction (convenience, ready availability, comfort, human contact) that contribute to effectiveness?
What guidelines (meta-guidelines) are appropriate for managing care and providing support regardless of what condition is being treated?
What are the best methods for prioritizing steps or processes of self-management support based on treatment effectiveness and cost effectiveness?
Relationships with physiciansWhat are effective approaches to integrating physicians with self-management support processes and providers?
What are effective ways to increase collaborative care?
Program designWhich programmatic components work under what circumstances? Which do not work?
What combination of services work and which combinations work better in what situations?
How do different components compare with respect to effectiveness; for example, what is the relative effectiveness of in-person coaching vs. telephone coaching vs. online interactive coaching?
What are useful methods of prioritizing and combining components?
What skills promote behavior change?
What are appropriate role definitions in self-management support? For example, what are the skills needed to provide remote telephone support, and how do these skills differ from those needed to provide face-to-face support?
What kind of experience (for example, specialist or generalist) is best for self-management support staffing?
What training (content and length) provides for the most effective self-management support staff?
How should self-management support providers' performance be evaluated?
What are the best self-management support tools to put into toolkits?
EvaluationWhat are sound analytic methods for evaluating clinical and economic outcomes of self-management support programs?
To what extent does continuous quality monitoring using administrative data have the potential to improve program quality and efficiency? How do database characteristics impact this potential?
What is the extent and effect of selection bias in these programs?
What is the impact of programs on health care expenses within specified time periods (for example, in the first year and/or the first 5 years)? What cost-savings are realized?
What return on investment can be expected over different time periods?
What is the alignment of cost with use and quality?
What is the impact of self-management support programs on productivity and absenteeism? What are good methods for evaluating this relationship?
OtherHow can the different movements represented by advocates of the chronic care model, disease management model, electronic medical records, and consumer-directed health care fit together?
To what extent can technology and economies of scale be leveraged to produce cost-effective programs for underserved populations?

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AHRQ Publication No. 08-0011

Page last reviewed November 2007
Internet Citation: Appendix 2. Research Questions and Needs: Patient Self-Management Support Programs: An Evaluation. November 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/ptmgmt/appendix2.html