Self-management interventions in primary care practices in France between 2010 and 2022: a descriptive national study.

Abstract

Aim: Our objective was to describe the self-management intervention (SMI) programmes carried out in primary care practices (PCPs) in France between 2010 and 2022.

Background: SMIs are included in the recommendations for chronic disease management, but access remains inequal. Primary care has been identified as a favourable setting for their development.

Methods: In partnership with the French Ministry of Health Office of Non-Communicable Diseases, we contacted all Regional Health Agencies (n = 18) to collect the following information from the self-management programme forms: year of authorization/declaration, SMI type, administrative structure, self-management and coordination team, and programme content.

Findings: At the 13 participating Regional Health Agencies, we identified 4,922 SMI programmes among which 18% (n = 889) were developed in primary care settings and 5.5% (n = 271) in PCPs. Among the 127 forms on SMI programmes at PCPs (2.6%), multi-professional PCPs (57.5%, n = 73) and healthcare centres (25.9%, n = 33) were the most represented. All programmes had a coordinator (mostly general practitioners, 34.7%, n = 24) among whom 69.7% (n = 69) were trained in coordination. The self-management team included a mean of 8.1 (5.5) primary care providers. The main themes were diabetes (34.6%, n = 44), diabetes and cardiovascular diseases (15.6%, n = 20), and cardiovascular disease (10.2%, n = 13). In France, self-management programmes in PCPs are still rare, lack a multimorbidity approach, and are carried out mainly in PCPs with inter-professional collaboration. A qualitative study to identify the barriers and levers to SMI programmes in PCPs may be particularly relevant.