Understand the nature of the illness; make informed choices; actively participate in decision-making with health professionals, family, and others; follow a treatment and care plan; monitor signs and symptoms; manage the impact of the disease on physical, emotional and social life; adopt a lifestyle that reduces risks and promotes health through prevention; have confidence in the ability to use support services.

These are the principles of self-management. We would argue that the issue of success or otherwise of self-management programs for people affected by chronic diseases is directly related to the characteristics of the population groups most affected by chronic illness. Most people affected by chronic illness are disadvantaged because they have a low socioeconomic status, are older and frail, have low literacy, are affected by mental illness, physical and intellectual disabilities or are from Indigenous backgrounds. In fact, there is already some Cochrane evidence that these programs seem to have short-term success but are not successful in the long term.

Only disadvantaged people affected by chronic illness can really give health services an understanding of what it is like to experience the care being provided; their carers are also in a unique position to inform services and service providers of the consumer and carer experience.

In the long term, people affected by chronic illness - and especially those most disadvantaged groups mentioned above- need a supportive environment which includes ongoing and positive interactions with health care providers, their family and friends and the broader environment.

Consumers affected by chronic illness need the support of a health system and a workforce that can act upon the real needs of consumers and their families and work in partnership with them, to seek practical ways to fulfill those needs

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