Self-management support in patients with multiple long-term conditions in the post-COVID-19 era

Background: Individuals who live with multiple long-term conditions (MLTCs) commonly experience poor quality of life, increased visits to healthcare services and premature mortality. While self-management support can help reduce this burden, existing research and medical guidelines typically focus on single conditions, making it difficult to effectively support those with MLTCs. Therefore, it is important to understand the support required for people with MLTCs to self-manage their health conditions effectively.Aim: This PhD aims to advance understanding of self-management support in people with MLTCs.Methods: A mixed-methods approach was used in this thesis and a series of studies (Chapters 3 to 5) have been presented.Results: The initial study involved conducting a mixed-methods systematic review to summarise findings related to the effectiveness and experiences of self-management interventions for people with MLTCs. Quantitative findings showed significant improvements in self-management behaviours, but limited effects on quality of life and mental health outcomes. Conversely, qualitative findings indicated that participants experienced improved quality of life and mental health.The subsequent qualitative study used interviews to explore the experiences and perceptions of self-management support in people with MLTCs and healthcare professionals. This study suggested that experiences of self-management support were multi-layered, and were shaped across an individual, healthcare and societal level.The final study used the Delphi technique to identify important components of self-management interventions, which could improve outcomes in people with MLTCs. This study highlighted the importance of a person-centred approach to self-management support, which is tailored to an individual’s needs and priorities.Together, the three studies informed recommendations for future self-management support interventions for people with MLTCs (Chapter 6). Conclusion: Overall, the findings presented in this thesis indicate that a person-centred approach to self-management support enables individuals to feel empowered and self-manage their health more effectively.