Self-management goal setting and action planning in primary care

It is becoming increasingly important for patients with chronic illnesses to acquire self-management skills. Self-management focusses on setting personal goals and planning actions. In general practices, the practice assistant usually helps patients define their goals and formulate plans of action. Ideally, patients participate in the shared decision-making process, but that is often not the case. During this research project, an approach was developed together with professionals and patients. This approach is aimed at supporting practice assistants and patients in making shared decisions about goals and plans of action. It focusses on finding out the patient’s story and tailoring the shared decision-making process to the patient. We have also developed an extensive training programme. The approach was considered useful in practice. However, it is important that general practices have a joint vision of self-management and shared decision-making to allow the approach to be implemented in current protocols. Organisational learning at primary care level seems promising in terms of achieving this goal