Does education of primary care professionals to support patient self-management improve patient outcomes in chronic disease management? updated systematic review.

BACKGROUND Our first systematic review included only two papers showing patient outcomes following health professional training for promoting patient self-management. AIM To present the updated review undertaken from September 2013 to August 2018. DESIGN & SETTING A systematic review was undertaken using the PRISMA guidelines, following the methodology of the first review and is outlined in the PROSPERO registered protocol (Database registration number: CRD42013004418). METHOD Six databases were searched - Cochrane Library, PubMed, ERIC, EMBASE, CINAHL and PsycINFO - in addition to Web searches, Hand searches and Bibliographies for articles published from September 1st, 2013 to August 31st 2018. RESULTS Our updated systematic review showed more evidence is now available with 18 papers in the five year period from the 4,284 abstracts located. Twelve of these papers showed a difference between intervention and control groups. Of the 18 papers identified, 11 were assessed as having a low risk of bias and five overall were rated of weak quality. The educational interventions with health professionals spanned a range of techniques and modalities and many incorporated multiple interventions including patient components. There may be lack of adoption due to several challenges, including that complex interventions may not be delivered as planned and are difficult to assess, and due to patient engagement and the need for ongoing follow-up. DISCUSSION More high quality research is needed on what methods work best and for which patients and what clinical conditions in the primary care setting. The practical implications of training healthcare professionals require specific attention.