Increasingly, patients are expected to take care of their health outside of medical settings (i.e. self-management).¹ Self-management includes the actions taken by individuals to lead a healthy lifestyle, manage their long-term condition and prevent further illness, both individually and with support from healthcare professionals.² It is widely promoted to empower patients, improve health outcomes, and reduce constraints on overstretched health systems.³ However, many individuals living with chronic conditions struggle to practise self-management effectively.^4–6 Yet, few studies have focused on how self-management is discussed in general practitioner (GP)–patient consultations, specifically using a patient-centred analysis.

When self-management is poorly integrated, it can lead to treatment non-compliance, negatively impacting on health outcomes.^7,8 GP consultations often present a major milestone for patients to stop and reflect on making changes that are actionable and sustainable for their health and wellbeing. However, GP consultations also present a missed opportunity to help patients in that regard. Limited studies have explored what ‘work’ is required from patients during and after the consultation regarding self-management.^9,10 In some circumstances, self-management is discussed hastily due to time pressures in a consultation;¹¹ and some self-management recommendations, whilst given with goodwill, may fail to acknowledge the specificities of the individual, such as daily routine, physical environment, social obligations, as well as beliefs and attitudes.^12–15 As a result, some patients leave the consultation feeling unsupported, not knowing what to do or how to start. Over time, a patient’s will and momentum to make changes diminish, and the patient returns to living in the status quo with no changes attempted, made or maintained to improve their health and wellbeing.