Patient expertise & self-management
Patient expertise and self-management are terms that have been co-popularized through the success of the Chronic Disease Self-Management Program and Expert Patient Program. This review looks at the intersection of literature that focuses on both patient expertise and self-management. These concepts are not well-defined and the treatment of each of these terms in the literature is diverse and occasionally contradictory, but patient expertise is generally regarded as some form of useful health knowledge and self-management can be understood as a set of behaviors including recognizing, treating, and preventing symptoms of illness. The relationship between these concepts is not established in the literature, so this review poses six potential relationship dynamics based on how they are interrelated within the literature set. Much of the research agrees that patients should be empowered, active, and informed, and these are the goals of operationalizing patient expertise and self-management. However, barriers to these goals include negative provider attitudes, extensive labor burden, and information relevance. In addition to these barriers to achieving the stated goals of this research, the corpus also exhibits significant limitations and gaps including diagnostic specificity, institutionalized verification, assumption of diagnostic onset, and disregarding disability. These limitations inhibit the utility of the research and the gaps call for further research to enhance academic understanding of this topic area.