Background: Comorbidity is an important adjustment measure in research focusing on outcomes such as health status and mortality. One recurrent methodological issue concerns the concordance of comorbidity data obtained from different reporting sources. The purpose of these prospectively planned analyses was to examine the concordance of comorbidity data obtained from patient selfreport survey interviews and hospital medical record documentation.

An SDM intervention for individuals with type 2 diabetes appears to be feasible and may improve major diabetes outcomes in primary care. SDM workbooks and activities can encourage patients to identify realistic diabetes goals with primary care providers. These results are encouraging. Future randomized trials with larger samples are warranted.

Case managers have an opportunity to fill the gaps in care for patients with multiple comorbid conditions. The case manager has the potential to address several of the issues identified by the patients in this study by helping comorbid patients develop self-management skills and tailoring supportive primary care interventions to meet individual patient needs.

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BACKGROUND: Telephone counseling in chronic disease self-management is increasing, but has not been tested in studies that control for quality of medical care.