The 'expert patient' approach for non-communicable disease management in low and middle income settings: When the reality confronts the rhetoric

作     者：Yue Xiao 

作者机构：The Center for Health Policy Evaluation and Technology Assessment The China National Health Development Research CenterBeijing 100910 China 

出 版 物：《Chronic Diseases and Translational Medicine》 (慢性疾病与转化医学（英文版）)

年 卷 期：2015年第1卷第3期

页      面：-页

学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

主　　题：Control Expert patient Management Non-communicable disease 

摘      要：This paper seeks to explore the relevance between the Western expert patient rhetoric and the reality of non-communicable diseases (NCDs) control and management in low and middle income settings from the health sociological perspective. It firstly sets up a conceptual framework of the expert patient or the patient self-management approach, showing the rhetoric of the initiative in the developed countries. Then by examining the situation of NCDs control and management in low income settings, the paper tries to evaluate the possibilities of implementing the expert patient approach in these countries. Kober and Van Damme s study on the relevance of the expert patient for an HIV/AIDS program in low income settings is critically studied to show the relevance of the developed countries rhetoric of the expert patient approach for the reality of developing countries. In addition, the MoPoTsyo diabetes peer educator program is analyzed to show the challenges faced by the low income countries in implementing patient self-management programs. Finally, applications of the expert patient approach in China are discussed as well, to remind us of the possible difficulties in introducing it into rural settings.