Patient and public involvement in chronic illness: beyond the expert patient

It is a truth universally acknowledged that patients with chronic illness should be involved in their care. It is also increasingly accepted that the public (as individuals, communities, and the voluntary sector) should be involved in designing, delivering, and evaluating services for chronic illness and in creating the conditions to support healthy living. In this article I examine these truths about patient and public involvement from four different perspectives: self management (drawing on biomedical and cognitive psychology), coping (sociology and narrative traditions), whole systems approaches (social ecology), and critical public health (table⇓). The article is based on my own reflections and analysis, but draws on several systematic reviews and meta-analyses on self management, patient empowerment, and community empowerment, as well as literature on illness narrative.1 2 3 ^w1-w16