Successes of a National Study of the Chronic Disease Self-Management Program

Ory, Marcia G.; Ahn, SangNam; Jiang, Luohua; Smith, Matthew Lee; Ritter, Philip L.; Whitelaw, Nancy; Lorig, Kate

doi:10.1097/mlr.0b013e3182a95dd1

Cited by 202 publications

(221 citation statements)

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“…Therefore, our study findings need to be tempered due to the possibility of methodological confounds such as unaccounted group demographic and health differences at baseline, relatively small sample sizes, and better awareness among those in a clinical trial or high quality routine diabetes care that emphasizes the importance of glycemic control. For example, participants in this study were, on average, younger than those studied in other recent CDSMP studies [23,29] . Additionally, the controls in this study appeared slightly healthier and better educated than their counterparts in the CDSMP intervention which might have made them more receptive to both clinical and community-based diabetes self-management and obesity prevention messages.…”

Section: Discussionmentioning

confidence: 79%

“…It has therefore been implemented worldwide for several chronic conditions such as heart disease, lung disease, arthritis, and diabetes as well as evaluated in various settings including the United States, Canada, United Kingdom, Australia, New Zealand, Bangladesh, China, Hong Kong, and The Netherlands [13][14][15][16][17][18][19][20] . While the original CDSMP validation study found improvements in general health status, health behaviors, and healthcare utilization [10] , the findings of more recent studies from a variety of self-management programs have been inconsistent [5,[21][22][23][24][25][26][27] . A recent literature review of randomized controlled trials comparing self-management support interventions for general chronic diseases vs usual care revealed mixed results.…”

Section: Introductionmentioning

confidence: 99%

“…However, this was a longitudinal study with no comparison group. Another related study found the CDSMP to improve lifestyle behaviors among patients with type 2 diabetes [23,29] . But again this was a single-group design.…”

Section: Introductionmentioning

confidence: 99%

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Impact of chronic disease self-management programs on type 2 diabetes management in primary care

Forjuoh¹

2014

WJD

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AIM:To assess the effectiveness of the Chronic Disease Self-Management Program (CDSMP) on glycated hemoglobin A1c (HbA1c) and selected self-reported measures. METHODS:We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls who received usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life (HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects. RESULTS:Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6% (P < 0.0001), but the reductions did not differ significantly between the two groups (P = 0.885). Few significant differences were observed in participants' diabetes self-care activities. No significant differences were observed in the participants' HRQOL, pain, or fatigue measures. CONCLUSION:The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Type 2 diabetes; Self-management; Chronic Disease Self-Management Program; Glycemic control; Glycated hemoglobin; Chronic disease Core tip: Diabetes is a serious chronic disease. One of the most studied evidence-based behavioral or self-care programs targeting chronic conditions including diabe- RANDOMIZED CONTROLLED TRIALSubmit a

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

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Impact of chronic disease self-management programs on type 2 diabetes management in primary care

Forjuoh¹

2014

WJD

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“…In addition, this education should be delivered across transitions in care so that self-management strategies are reinforced in health care and community settings. 6 Despite the promising evidence for self-management programs, referral to and enrollment in these programs is low. Research studies examining factors associated with the enrollment in self-management programs have reported enrollment rates ranging from 22.8% 8 to as high as 59.6%.…”

Section: Background and Significancementioning

confidence: 99%

Untitled

2017

ACI Open

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Background Transient ischemic attack (TIA) is a strong predictor of subsequent stroke. Measures to decrease stroke incidence following TIA include medical management, risk factor optimization, and lifestyle modification. Best practice recommendations for stroke care promote individualized education on self-management across transitions from hospital to community settings. In the study region, patients with TIA are referred to the stroke prevention clinic where they receive rapid stroke assessment, risk factor management, education, and referral to risk reduction programs. Long-term management is typically the responsibility of primary care providers who may have limited resources for self-management support. Promotion of existing chronic disease self-management (CDSM) programs can complement this support. Objective The objective of our project was to examine the feasibility and acceptability of an electronic referral system to an existing CDSM program to facilitate selfmanagement support for persons with TIA. Methods We performed a descriptive evaluation of a quality improvement project that involved development and implementation of a new electronic referral (eReferral) process. A partnership between the stroke prevention clinic and the regional Living Healthy CDSM program was developed alongside a clinical information system redesign implementing an eReferral system. Results Referral to the Living Healthy CDSM program was offered to each patient at the stroke prevention clinic. Of 912 patients seen over a 6-month period, 62 (7%) agreed to be referred. Of these, 23 (37%) were registered or waitlisted. Conclusion Formation of a partnership and implementation of the eReferral system facilitated referral to the Living Healthy CDSM program. Despite low referral and enrollment rates, the eReferral system provides one option to enhance self-management support for persons with TIA.

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“…HARC was established by the Health Foundation of South Florida in 2008 to make evidence-based programs such as EF, LHP, MOB, and HI available to older adults in three southeast counties of South Florida: Miami-Dade, Broward, and Monroe Counties. Little is known about the effectiveness of these programs (Batra, Melchior, Seff, Frederick, & Palmer, 2012;Ory et al, 2013Ory et al, , 2014.…”

Section: Limitationsmentioning

confidence: 99%

Investigating the Outcomes of a Physical Activity Program offered to Older Adults in South Florida and Understanding the Correlates of Completion

Batra¹

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Successes of a National Study of the Chronic Disease Self-Management Program

Abstract: This National Study of CDSMP (National Study) demonstrates the successful translation of CDSMP into widespread practice and its potential for helping the nation achieve the triple aims of health care reform.

Cited by 202 publications

References 14 publications

Impact of chronic disease self-management programs on type 2 diabetes management in primary care

Impact of chronic disease self-management programs on type 2 diabetes management in primary care

Untitled

Investigating the Outcomes of a Physical Activity Program offered to Older Adults in South Florida and Understanding the Correlates of Completion

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