Self-management support in patients with multiple long-term conditions in the post-COVID-19 era
Dr Ffion Curtis, Dr Michelle Hadjiconstantinou, Prof Kamlesh Khunti
Application deadline: Sunday, August 08, 2021
Funded PhD Project (European/UK Students Only)
About the Project
Multimorbidity has been identified as a global research priority and as such this is an important and rapidly evolving field of research with the potential for significant impact.
The pattern of health and disease in our population is ever evolving and we need to be responsive to these changes. Multimorbidity is defined as the coexistence of 2 or more long-term health conditions and is associated with increased use of health services, reduction in both quality of life and life expectancy. The number of people living with multiple health conditions continues to increase and meeting their needs will be one of the biggest challenges facing the NHS (Stafford et al., 2018). Then, adding to this; the COVID-19 pandemic where a strong association has been identified between multimorbidity and mortality in those with COVID-19 (Iaccarino et al., 2020) and yet research on this topic is sparse. Consequently, there is little public health advice tailored to this growing proportion of the world’s population (mair et al., 2020).
Self-management support is an established strategy to reduce the burden of chronic diseases (O’Conell et al., 2018). Interventions aim to encourage and support patients whilst highlighting their crucial role in maintaining health and function. Core elements include establishing action plans, recognizing the importance of goal setting, identifying barriers and the development of problem solving skills to overcome them (Wagner et al., 2001). Most approaches have tended to focus on single conditions and outcomes and but little is known about the impact in patients with multiple chronic conditions (Contant et al., 2019) which is potentially more complex and evidence is needed to inform future policy and practice. We also need to explore the impact of COVID-19 restrictions on delivery and access to self-management programs as there will have been increased reliance on digital delivery and it is likely patients will have experienced increased burden of self-management of their condition. The social gradient in chronic disease, and efficacy of self-management support is well-documented and there is evidence that many groups who are already subject to disadvantage and worse health outcomes are also more likely to experience further health inequalities as a consequence of digital exclusion (Honeyman et al., 2020). A core part of this work will include shining a light on and developing guidance to mitigate against potentially widening health inequalities for patients with multimorbidity.
Whilst the focus and methodology of this program of work will be informed by evidence generated in objective 1 (systematic review) and the previous experience and expertise of the successful candidate it will broadly aim to advance our understanding of multimorbidity and self-management support in multi-morbid patients as we emerge from the COVID-19 pandemic.
The overall aim for the studentship is: To advance understanding of multimorbidity and self-management support as we emerge from the COVID-19 pandemic.
The objectives for this studentship are:
- To systematically review the evidence to identify effective patient focused multimorbidity self-management interventions. To include both quantitative and qualitative studies, with meta-analyses and meta-syntheses where appropriate.
- To utilise appropriate qualitative methods (i.e. interviews, focus groups) to explore HCP and patient experiences and perceptions of multimorbidity self-management.
- To map current referrals, provision and/or access to multimorbidity self-management support identifying any inequities post COVID-19 (e.g. data linkage study, geo-mapping).
- To develop a pilot study exploring a self-management intervention program in patients with multimorbidity.
Entry requirements:
Applicants are required to hold/or expect to obtain a UK Bachelor’s Degree 2:1 or better (or overseas equivalent) in a relevant subject.
The University of Leicester English language requirements apply where applicable.
Application advice:
To apply please refer to the guidance at: https://le.ac.uk/study/research-degrees/funded-opportunities/diabetes-hs-curtis-2021
Project / Funding Enquiries: Dr Ffion Curtis: fc169@leicester.ac.uk
Application enquiries to pgradmissions@le.ac.uk
For more information and to apply, click here.
Funding notes
This 3-year PhD Studentship provides:
- UK/EU tuition fee waiver
- Annual stipend at standard UKRI rates (£15,609 for 2021/22)
References
Stafford, M., Steventon, A., Thorlby, R., Fisher, R., Turton, C. and Deeny, S. (2018). Briefing: Understanding the health care needs of people with multiple health conditions. The Health Foundation.
O’Conell, S., Mc Carthy, V. J. C., Savage, E. (2019). Frameworks for self-management support for chronic disease: a cross-country comparative document analysis. BMC Health Services Research. 18: 583
Honeyman, M., Maguire, D., Evans, H., and Davies, A. Digital technology and health inequalities: a scoping review. (2020). Cardiff: Public Health Wales NHS Trust
Mair, F.S., Foster, H.M., Nicholl, B.I.(2020) Multimorbidity and the COVID-19 pandemic – An urgent call to action. Journal of Comorbidity. doi:10.1177/2235042X20961676
Iaccarino, G, Grassi, G, Borghi, C, et al. (2020) Age and multimorbidity predict death among COVID-19 patients results of the SARS-RAS study of the Italian Society of Hypertension. Hypertension; 76: 366–372.
Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. (2001) Improving chronic illness care: translating evidence into action. Health Aff (Millwood);20:64–78
Contant, É., Loignon, C., Bouhali, T. et al. (2019) A multidisciplinary self-management intervention among patients with multimorbidity and the impact of socioeconomic factors on results. BMC Fam Pract 20, 53. https://doi.org/10.1186/s12875-019-0943-6
Published on: 6 Jul 2021