How effective are the linkages between self-management programmes and primary care providers, especially for disadvantaged patients?

Objectives: To describe the extent and effectiveness of strategies that have been used to improve linkages between primary healthcare (PHC) and chronic disease self-management programmes, especially for disadvantaged patients. Methods: A systematic review of the published peer-reviewed literature. Studies conducted in an Organisation for Economic Co-operation and Development country evaluating a group self-management programme of at least 4-week duration with some linkage between PHC and the programme were included. Linkage strategies were qualitatively derived. Studies were descriptively analysed in terms of the type of self-management programme, strategy for linking with PHC, culturally and linguistically diverse and socio-economic status and impact on health service usage. Results: Sixteen studies were identified that used linkage strategies for a variety of functions-supporting communication, ongoing clinical care, programme development, recruitment or implementation. Of the four studies that evaluated impact on health service use, only one reported a positive change. Discussion: Few programmes of self-management support included specific strategies to increase linkages with PHC as part of their intervention. There is insufficient evidence to determine which strategies or linkages are more effective and in what context.