What is the breadth and depth of self-management interventions?
Implementing Best Practice for Chronic Disease Management for Osteoarthritis Hip & Knee: Where does self-management fit in?

Dr Caroline Brand, Director
Clinical Epidemiology & Health Services Evaluation Unit
Royal Melbourne Hospital

The burden of osteoarthritis hip and knee is increasing, and can be measured by rising demand
for joint replacement surgery (JRS) as well as population disability and health care costs. The
rising burden of the condition in conjunction with documented gaps in quality of care are driving
health service redesign in which chronic disease management programs are expected to
improve uptake of evidence into practice, standardise and coordinate care across health care
providers and health care sectors, and provide support for consumer self management of their
condition.

Management for mild – moderate osteoarthritis (OA) prioritises implementation of effective non
pharmacological therapies, including exercise and nutritional lifestyle behavioural changes.
Severe hip and knee OA can be effectively treated with joint replacement surgery (JRS).
Therefore, OA is an exemplar condition for a CDM model that focuses on support for condition
self management and coordination of care to provide effective, appropriate and timely
intervention throughout the condition continuum.

In 2004, a clinical pathway (OACP) was mapped by a multidisciplinary group in conjunction
with extensive consumer consultation. The OACP was piloted in 6 diverse settings (acute care,
general practice, metropolitan & rural settings). There was variable implementation of support
for patient condition self management. Barriers to OACP implementation, and solutions for
future translation of the model were documented. In particular, barriers to patient access and
sustained uptake of conservative therapy recommendations were elicited. Reasons for
differences in clinician and patient identified barriers between health care providers and
healthcare settings, and implications for future policy and planning, will be discussed.


Self-Management at the coalface: the Flinders model of clinician administered
self-management support

Associate Professor Malcolm Battersby
Flinders University, South Australia

People with chronic conditions are self-managing. Health professionals are able to assist some people with chronic conditions to improve their self-management.

This process has been called ‘self-management support’. Numerous programs either disease focussed or generic, directed at the individual with a chronic condition have demonstrated efficacy in improving self-management behaviours and health outcomes. More recently attention has been directed to education for health professionals which will enhance their capacity to provide self-management support.

This presentation will describe the Flinders model of self-management support which provides a motivational approach to determining what interventions can improve self-management and health outcomes for people with long term conditions.

Self-management education en mass: Effectiveness of a population based
multi-media campaign "Back pain, don't take it lying down"

Professor Rachelle Buchbinder
Monash Department of Clinical Epidemiology
Cabrini Hospital

Abstract to come.

Why is the vision for chronic disease self-management important to the Private Health insurance Industry?

Dr Michael Armitage, Australian Health Insurance Association

Why is the vision for chronic disease self-management important to the Private Health insurance industry?

• Private Health Insurance Overview – A Newly Legislated Frontier
• Examples (and Issues)
• Clinical Effectiveness
• Cost Effectiveness
• Towards a Positive Future