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Thursday 29 September 2016
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Researchers question whether expert patient programmes cut healthcare use

Researchers in this week's British Medical Journal (BMJ) have examined evidence and questioned whether "expert patients" consume fewer health resources (How effective are expert patient (lay led) education programmes for chronic disease? BMJ;334:1254-6).

The expert patient programme (EPP) has been heavily promoted by the UK government as part of a drive to reduce use of acute healthcare and deliver long-term cost savings.

In 2001, the chief medical officer, Sir Liam Donaldson, concluded that self-management programmes for chronic diseases would improve health status, slow the progression of disease, and reduce healthcare use, and that the NHS should invest heavily in the EPP.

To date, the Department of Health has invested £18m in the programme, which will be rolled out to 100,000 patients by 2012.

Yet four trials in the UK indicate that although lay-led programmes may increase patients' confidence to manage their disease, there is little evidence to date that they make an important impact on either hospital admissions or the use of other healthcare resources in the NHS.

Although improvements in confidence are welcome, questions remain about its impact on health in patients in the UK, say the authors, from Queen Mary's School of Medicine and Dentistry in London.

They suggest that lay-led programmes in the UK need evaluation before they can be recommended over other programmes with established impact.

They also point out that primary care trusts or general practice commissioning groups will need to consider carefully the costs of investing in this programme compared with other rehabilitation programmes for chronic disease.