Evidence Suggesting That a Chronic Disease Self-Management Program Can Improve Health Status While Reducing Hospitalization

Lorig, Kate; Sobel, David S.; Stewart, Anita L.; Brown, Byron W.; Bandura, Albert; Ritter, Philip L.; González, Virginia; Laurent, Diana; Holman, Halsted R.

doi:10.1097/00005650-199901000-00003

Cited by 1,947 publications

(1,668 citation statements)

References 8 publications

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“…31 Self management approaches also use peer leaders, which would address the importance of mentors identified in this study. Self management approaches have been used with patients with arthritis and diabetes, 32,33 but to our knowledge, have not been used with people with SCI. Any approach to education, however, needs to focus on the topics of most importance to people with SCI.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of issues associated with the maintenance and improvement of long-term health in people with SCI

Manns

May

2006

Spinal Cord

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Study design: Qualitative design using focus groups. Objective: To explore the perceptions of people with SCI and their caregivers about information needs and service delivery options that may assist them to maintain or improve their long-term health. Setting: Province wide project in Alberta, Canada. Methods: Eight focus groups were conducted; five with community dwelling people with SCI and three with unpaid caregivers (family and friends). Content analysis was used to identify categories and themes arising from the data. Results: The findings from the study are broader than the original objective to explore information needs and service delivery options to promote long-term health. The participants more globally discussed factors that contribute to or provide barriers to their long-term health. Those factors are captured in five categories, including readiness, information pathways, community health care, health promotion, and contextual factors. A framework that illustrates the relationships between categories was constructed. Conclusion: The framework identifies areas to target in programmes designed to reduce or prevent secondary conditions in people with SCI.

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Section: Discussionmentioning

confidence: 99%

Perceptions of issues associated with the maintenance and improvement of long-term health in people with SCI

Manns

May

2006

Spinal Cord

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“…If self-management is to be of use in hypertension, there may therefore be a need both to promote selfmonitoring and then also further steps to encourage individuals to use the results of that monitoring to improve the control of their condition. In a trial of an educational 'chronic disease self-management programme' aimed at a group of 952 subjects with a variety of chronic diseases, Lorig et al 17 showed that their intervention improved health behaviours and health status, and reduced hospitalisations, during 6 months of follow-up. Again, long-term benefits are unknown.…”

Section: Discussionmentioning

confidence: 99%

Patients' experiences and opinions of home blood pressure measurement

Rickerby

Woodward

2003

J Hum Hypertens

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“…Therefore, participants in any one program have a variety of chronic conditions. In a randomized study, participants (n ϭ 952) with arthritis, heart disease, lung disease, or stroke were all placed together in the same 14-hour, peerled intervention (12). Outcome data suggest that intervention participants, when compared with randomized controls at 6 months, significantly improved their selfmanagement behaviors, improved their health status (role activities, health distress, disability, and fatigue), improved their self efficacy, and decreased the number of days in the hospital (P Ͻ 0.05) (12).…”

Section: Background the Arthritis Self-management Programmentioning

confidence: 99%

“…Unlike the ASMP, the CDSMP is a generic program that individuals with many different types of chronic conditions attend at the same time. In an initial randomized study, persons with arthritis who attended the CDSMP workshop showed improvements in health behaviors and health status (12). Both the ASMP and the CDSMP are large programs in the United States, Great Britain, Australia, New Zealand, and Canada.…”

Section: Introductionmentioning

confidence: 99%

A disease‐specific self‐help program compared with a generalized chronic disease self‐help program for arthritis patients

Lorig¹,

Ritter²,

Plant³

2005

Arthritis & Rheumatism

221

212

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Objective. Both the Arthritis Self-Management Program (ASMP) and the generic Chronic Disease Self-Management Program (CDSMP) have been shown to be successful in improving conditions in patients with arthritis. This study compared the relative effectiveness of the 2 programs for individuals with arthritis. Methods. Patients whose primary disease was arthritis were randomized to the ASMP (n ‫؍‬ 239) or to the CDSMP (n ‫؍‬ 116). Analyses of covariance were used to compare the outcome measures for the 2 programs at 4 months and 1 year. Measures included quality of life outcomes (self reported, health distress, disability, activity limitation, global health, pain, and fatigue), health behaviors (practice of mental stress management, stretching and strength exercise, aerobic exercise), self efficacy, and health care utilization (physician visits and hospitalizations). Results. Both programs showed positive results. The disease-specific ASMP appeared to have advantages over the more generic CDSMP for patients with arthritis at 4 months. These advantages had lessened slightly by 1 year. Conclusion. The disease-specific ASMP should be considered first where there are sufficient resources and participants. However, both programs had positive effects, and the CDSMP should be considered a viable alternative. KEY WORDS. Patient education; Self management; Arthritis; Randomized trial. INTRODUCTIONThe Chronic Care model and the Institute of Medicine have established self-management programs as a necessary component of good care for persons with chronic disease (1-5). Within the model, such programs are known as self-management support, which is how providers and systems support patients in their self-management efforts. Over the past 2 decades, there have been many examples of effective self-management support (2,6). Most of these programs have been disease specific, whereas a few are more generic. One of the major questions arising from past self-management studies is how to best understand the effectiveness of different programs. In this report, we examine the specific issue of the relative effectiveness of a disease-specific self-management program versus a generic self-management program for individuals with arthritis and discuss the policy implications for the findings.The Arthritis Self-Management Program (ASMP), also known as the Arthritis Self-Help Course and Challenging Arthritis, is now more than 25 years old. It has been found to be useful for persons with arthritis (7-9).In the past 10 years, the Chronic Disease Self-Management Program (CDSMP), also known as the Expert Patient Program, has been developed and evaluated (8,10,11). Unlike the ASMP, the CDSMP is a generic program that individuals with many different types of chronic conditions attend at the same time. In an initial randomized study, persons with arthritis who attended the CDSMP workshop showed improvements in health behaviors and health status (12). Both the ASMP and the CDSMP are large programs in the United States, Great Britain, Australia, New Zeala...

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Evidence Suggesting That a Chronic Disease Self-Management Program Can Improve Health Status While Reducing Hospitalization

Cited by 1,947 publications

References 8 publications

Perceptions of issues associated with the maintenance and improvement of long-term health in people with SCI

Perceptions of issues associated with the maintenance and improvement of long-term health in people with SCI

Patients' experiences and opinions of home blood pressure measurement

A disease‐specific self‐help program compared with a generalized chronic disease self‐help program for arthritis patients

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