Drivers and barriers to promoting self-care in individuals living with multimorbidity: a cross-sectional online survey of health and care professionals

Objective Investigate knowledge, attitudes, and perceptions of health and care professionals (H&CPs) in England concerning drivers and barriers for promoting self-care in service-users with multimorbidity. Design A cross-sectional online survey of the health and care workforce. Setting Health and social care workforce. Participants Eighty-eight health and social care professionals in England. Methods A cross-sectional online survey administered via Imperial College Qualtrics platform. Questions were asked about perceived drivers and barriers to promoting self-care in individuals with multimorbidity, including mental health. Results Extant barriers associated with service-users ability and opportunity to self-care were feelings of loneliness and social isolation (18.9%; n=61), mobility and access issues (14%; n=45). Strategies deployed by H&CPs to support self-care were social prescribing (17.9%; n=59), helping service-users to monitor their symptoms (15.2%; n=50), referring to recognised programmes to support self-management (13.9%; n=46), knowledge and understanding about the benefits of self-care (91.8%; n=67), the purposes of prescribed medicines (83.3%; n=60), and support for self-care (91.7%; n=66) were considered key drivers of successful self-management and to engagement between service-users and service providers. Service providers’ reported gaps in their knowledge including how to improve practical interactions to sustain health seeking behaviours by service-users (30.6%; n=49), health coaching (21.9%; n=35), improved understanding about effective self-care interventions (21.3%; n=34) and improving self-care in relation to medicines use (20%; n=32). Most respondents (92.2%; n=71) reported that the COVID-19 pandemic had highlighted the need for self-care, and (42.7%; n=32) agreed that the pandemic had a positive impact on their ability to promote self-care among service-users. Conclusions Self-care is important for service-users who live with multimorbidity. H&CPs are in a unique position to influence lifestyle choices and health-seeking self-care behaviours. Raising awareness about the importance of self-care, health literacy, knowledge, understanding and skills among service-users and providers is key to improving supported self-care. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was reviewed and received a favourable opinion from Imperial College Research Ethics Committee (ICREC # 21IC6770). All data generated or analysed during this study are included in this published article. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable All relevant data are within the manuscript and its Supporting Information files.