OP169 ‘It feels like the system is almost against you’: Self-management of multiple long-term conditions amongst people experiencing socioeconomic deprivation

Background

Multiple long-term conditions (MLTCs) have a higher prevalence in socioeconomically deprived populations. Self-management strategies are vital for people with MLTCs, and effective strategies are associated with improved health outcomes. However, self-management of MLTCs are less beneficial for those experiencing socioeconomic deprivation, creating further health inequalities. The aim of this research is to explore how to optimise self-management of MLTCs in people experiencing socioeconomic deprivation.

Methods

Semi-structured one-to-one interviews (face-to-face and remote) with adults living in London and Sheffield, with MLTCs who are experiencing socioeconomic deprivation. Participants were recruited through GP practices, community channels and social media. Interview transcripts were analysed thematically using NVivo software to explore the barriers and facilitators to self-management.

Results

28 participants, aged 20 to 90 years, with MLTCs were interviewed from an ethnically diverse sample. The study is due to end in September 2023 and the analysis is ongoing. Preliminary findings reveal barriers and challenges to self-management experienced by participants. Among these were an inability to afford daily necessities such as food and heating for the home; both of which were necessary for maintaining a good quality of life. Difficulties accessing the services and support to meet individual health needs were exacerbated by living in an area of deprivation. Unemployment, due to poor health, and the subsequent loss of income, routine, and sense of purpose compounded mental health problems and led to social isolation. Many lacked good understanding about all their conditions to make decisions about their own health due to health literacy barriers and finding it difficult to ask questions when visiting their GP. Examples of the latter included feeling dismissed, as well as difficulties describing and articulating symptoms. Facilitators of self-management include access to health specialists and consultants, informal support such as family, friends and peers, and opportunities to increase social interaction.

Conclusion

Understanding the perspectives of people experiencing socioeconomic deprivation and living with MLTCs is critical, especially during the cost-of-living crisis and as demand for services increases. More recognition of the impact that socioeconomic deprivation has on people’s ability to self-manage will lead to better self-management support and interventions. Recommendations on ways to improve self-management and reduce the inequity in healthcare will be discussed.