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Patients consistently report wanting more, and better, information about their health, health care, and treatment options. Providing this information is challenging. One approach is coaching patients to ask questions during consultations. In the linked study ( 10.1136/bmj.a485 ), Kinnersley and colleagues report a systematic review which shows that this approach has relatively little effect. 1 So what is the underlying rationale for improving health information for patients, and what interventions are likely to work?
Some people argue that improving patient information and educating patients about their health problems is ethically essential and needs no further justification. 2 Others point to the benefits of patient education, in terms of improved self care, 3 enhanced patient satisfaction, 4 improved health status, 5 and reduced healthcare expenditure. 6 Improving clinical outcomes, however, needs more than just information-it requires a partnership between patients and their health professionals, with the patient actively engaged in self care.
People living with long term conditions face three challenges: medical management, emotional management, and role management. 7 Most health professionals focus on medical management, which includes monitoring symptoms, changing health behaviours (such as eating a healthier diet, taking more exercise, taking drugs regularly), and working with health professionals. For the patient, emotional management-dealing with the emotional consequences of having a long term condition, which include anger, guilt, despair, and frustration-can be equally challenging and equally important for quality of life. Role management-coming to terms with a change in life role (for example, from "healthy" to "sick" or from "provider" to "cared for," with the connotation of "burden") is also a substantial challenge. 7
Information is a prerequisite for dealing with these challenges, but it is...