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Zelfmanagement bij chronische ziekten

  • Beschouwing
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Huisarts en wetenschap Aims and scope

Samenvatting

Trappenburg J, Jonkman N, Jaarsma T, Van Os-Medendorp H, Kort H, De Wit N, Hoes A, Schuurmans M. Zelfmanagement bij chronische ziekten. Huisarts Wet 2014;57(3):120–4.

Zelfmanagement is trendy: algemeen is het een erkend onderdeel van de behandeling van chronische aandoeningen en de verwachtingen zijn torenhoog. Toch stuit brede invoering van zelfmanagementprogramma’s op beletsels. Er is veel wetenschappelijk onderzoek gedaan, maar er is nog geen eenduidig bewijs voor de effectiviteit van zelfmanagementprogramma’s, onder andere door grote verschillen in terminologie. Er zijn zeker indicaties dat zelfmanagement potentie heeft, maar lang niet alle patiënten reageren op de interventies. De variatie tussen programma’s en patiëntenpopulaties is enorm en daardoor is moeilijk te bepalen wat nu precies werkt en bij wie. De begripsverwarring, ook bij zorgverleners, beleidmakers en publiek, herbergt het risico dat ‘zelfmanagement’ een nietszeggend containerbegrip wordt.

Deze beschouwing verduidelijkt de terminologie en evalueert de bewijskracht voor de effectiviteit van zelfmanagementprogramma’s. Overduidelijk is dat niet alle patiënten profiteren van de huidige one-size-fits-all-benadering. Er is dus behoefte aan zorg-opmaat, afgestemd op de individuele patiënt. Dat vergt nader onderzoek naar de succesfactoren: welk type interventie, met welke inhoud, in welke vorm en in welke intensiteit is het kansrijkst bij welk type patiënt? Het onderzoeksconsortium Tailored Self-management & Ehealth (TASTE) probeert deze factoren systematisch te ontrafelen en op maat gesneden interventies te ontwikkelen. Vooralsnog doen eerstelijnszorgverleners er goed aan, de geschiktheid van een zelfmanagementinterventie voor iedere patiënt goed af te wegen.

Abstract

Trappenburg JCA, Jonkman N, Jaarsma T, Van Os-Medendorp H, Kort H, De Wit NJ, Hoes AW, Schuurmans M. Self-management and chronic disease. Huisarts Wet 2014;57(3):120–4.

Self-management is trendy: it is a recognized component of the treatment of chronic disorders and expectations are high. Even so, there are barriers to the introduction of self-managements programmes. Despite considerable research, there is still no hard evidence of the efficacy of self-management programmes, in part because of differences in terminology. There are indications that self-management has potential, but not all patients respond to these interventions. Differences between programmes and patient populations make it difficult to establish which programme works for which patient group. Terminological confusion, also among care providers, policy makers, and the public, harbours the risks that ‘self-management’ may become a meaningless concept.

This article clarifies terminology and evaluates the strength of evidence for the efficacy of self-management programmes. It is clear that not all patients benefit from the ‘one size fits all’ approach and that there is a need for tailored care, based on the individual patient. This requires further investigation of determinants of success; which type of intervention, and with what content, form, and intensity, has the great est likelihood of success in specific patient groups. The research consortium Tailored Self-management & Ehealth (TASTE) is trying to unravel these factors and to develop tailored interventions. For the moment, primary care practitioners would do well to evaluate the suitability of self-management programmes for individual patients.

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Author information

Authors and Affiliations

  1. afdeling Revalidatie, Verplegingswetenschap en Sport, UMC Utrecht, 85500, 3508, huispost W01.121, Utrecht, The Netherlands

    Jaap Trappenburg, Nini Jonkman &  Marieke Schuurmans

  2. Universiteit van Linköping, Norrköping, Sweden

    Tiny Jaarsma

  3. afdeling Dermatologie, UMC Utrecht, Utrecht, The Netherlands

    Harmieke van Os-Medendorp

  4. Research Centre for Innovation in Health Care , Utrecht, Utrecht University, Utrecht, The Netherlands

    Helianthe Kort

  5. Julius Center for Health Sciences and Primary Medicine, Utrecht, The Netherlands

    Niek de Wit &  Arno Hoes

Authors
  1. Jaap Trappenburg
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  2. Nini Jonkman
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  3. Tiny Jaarsma
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  4. Harmieke van Os-Medendorp
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  5. Helianthe Kort
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  6. Niek de Wit
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  7. Arno Hoes
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  8. Marieke Schuurmans
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Additional information

UMC Utrecht, afdeling Revalidatie, Verplegingswetenschap en Sport, Postbus 85500, huispost W01.121, 3508 GA Utrecht: dr. J.C.A. Trappenburg, fysiotherapeut, bewegingswetenschapper en post-doc onderzoeker; N.H. Jonkman, promovendus; prof.dr. M.J. Schuurmans, hoogleraar Verplegingswetenschap. Universiteit van Linköping, Norrköping (Zweden): prof.dr. T. Jaarsma, hoogleraar Verplegingswetenschap. UMC Utrecht, afdeling Dermatologie: dr. H. van Os-Medendorp, verplegingswetenschapper en epidemioloog. Hogeschool Utrecht, Kenniscentrum Innovatie van Zorgverlening, Utrecht: prof.dr. H.S.M. Kort, lector Vraaggestuurde Zorg en hoogleraar Building Healthy Environments for Future Users. Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht: prof.dr. N.J. de Wit, hoogleraar Huisartsgeneeskunde; prof.dr. A.W. Hoes, hoogleraar Klinische Epidemiologie en Huisartsgeneeskunde . Correspondentie: j.c.a.trappenburg@umcutrecht.nl. Mogelijke belangenverstrengeling: niets aangegeven.

Dit artikel is een bewerkte vertaling van: Trappenburg J, Jonkman N, Jaarsma T, Van Os-Medendorp H, Kort H, De Wit N, et al. Self-management: one size does not fit all. Patient Educ Couns 2013;92:134-7. Publicatie gebeurt met toestemming van de uitgever.

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Trappenburg, J., Jonkman, N., Jaarsma, T. et al. Zelfmanagement bij chronische ziekten. HUISARTS WETENSCHAP 57, 120–124 (2014). https://doi.org/10.1007/s12445-014-0064-3

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  • DOI: https://doi.org/10.1007/s12445-014-0064-3

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