Introduction
The Chronic Disease Self-Management Program (CDSMP)
Materials and methods
Search strategy
Inclusion procedure
Results
Author, year | Sample characteristicsa
| Study design Follow-up | Results (significance P ≤ 0.05), main effects, effect sizes (when available) and measurements | Other characteristics |
---|---|---|---|---|
Griffiths et al. 2005
|
N = 476; 49 years (9.7); 43% Bangladeshi adults | RCT: intervention and waiting list control group. Pre-test and 4-month post-test study | Improvement: Self-efficacy, Self-care behaviour No improvement: Communication, Anxiety, Pain, Fatigue, Shortness of breath, visits to a physician, Depression and Quality of Life. Measurements: self-administered version of the Chronic Disease Self-management questionnaire (Lorig et al. 1996), HADS (anxiety and depression) and EQ5D (health status). | T: pairs of trained and accredited Bangladeshi lay tutors with chronic diseases. D: Diabetes (68%), Asthma (16%), Arthritis (9%) and Cardiovascular diseases (6%). Also comorbidity. L: 6 times for 3 h, according to detailed CDSMP manual A: 0 sessions N = 50, 1–2 sessions N = 118, 3–6 sessions N = 122 S: Adapted CDSMP into the Sylheti dialect and Islamic culture. |
Elzen et al. 2006
|
N = 139; 68 years (6.3); 36.8% Mainly patients attending hospital outpatient clinic | RCT: intervention and control group, 6 weeks and 6 months post-test. | No improvement:
6-week and 6-month outcome
Self-efficacy, Exercise, Cognitive symptom management, Communication, Role limitations, Social functioning, General health and Vitality. Measurements: self-administered version of the Chronic Disease Self-management questionnaire (Lorig et al. 1996) and GSES-16 (self-efficacy scale). | T: pairs of trainers Psychology PhD and peer leaders D: Diabetes (32%), Lung disease (27%), Arthritis (33%) and heart disease (6%). Also comorbidity. L: 6 times for 2.5 h, according to detailed CDSMP manual. A: 5.6 sessions G: 10–13 participants |
Fu Dongbo et al. 2003
|
N = 954; 64 years (10); 28% Urban communities Shanghai, China | RCT: intervention and waiting list control group Pre-test and 6-month post-test | Improvement: Cognitive symptom management (.38), Exercise (.16), Self-efficacy (.26), self-rated health (−.33), Health distress (−.22), Shortness of breath (−.14), Pain (−.16), Disability (.27), Depression (−.10), Social roles (−.15) and Hospitalization (−.17) No improvement: Communication with medical doctor, Physician and Emergency Room (ER) visits and Nights in hospital. Measurements: self-administered Chinese version of the Chronic Disease Self-management questionnaire (Lorig et al. 1996) | T: pairs of lay leaders and professionals, some with a chronic disease D: Hypertension (56%), Heart disease (34%), arthritis (30%), lung disease (19%), diabetes (15%), cancer (3%) and other diseases (21%) L: 7 times 2–2.5 h, according to detailed CDSMP manual. A: 20% <7 sessions G: 10–15 participants S: culturally adapted and translated into the Shanghai Chronic Disease Management Program |
Lorig et al. 2003
|
N = 551; 56 (14) years; 21% Hispanics in North-Carolina area | RCT: intervention group and waiting list control group. Pre-test and 4 months and 1 year post-test | Improvement:
Four-month outcome
Self-reported health (−.48), Health distress (−.47), Fatigue (−.27), Pain/Discomfort (−.23), Role function (−.26), Exercise (.28), Communication with physician (.34), Mental stress-management (.71), Self-efficacy (.16) and ER visits (−.29)
One-year outcome
Same aspects and Tobacco use, Self-efficacy and ER visits No improvement:
Four month outcome
Physician visits, Tobacco use and Hospital days
One-year outcome Physician visits and Hospital days Measurements: self-administered version of the Chronic Disease Self-management questionnaire (Lorig et al. 1996) | T: pair of trained peer leaders D: Heart disease (19%), Hypertension (52%), Diabetes (45%), Lung disease (19%), Hypolipidemias (28%), Arthritis (15%). Also comorbidity. L: 6 times for 2.5 h, according to detailed CDSMP manual A: Mean = 4.3 sessions G: 10–15 participants (patients, significant others) S: important cultural adaptation and translation to the version Tomando |
Lorig et al. 1999
|
N = 952; 65.4 years (range 40–90 years); 35% English community | RCT: intervention group and control group. Pre-test and 6-month post-test | Improvement: Physical exercise, Cognitive symptom-management, Communication with medical doctor, Social roles, self-rated health, Disability and Health distress, Hospitalizations and Nights in hospital No improvement: Pain, Physical discomfort, Shortness of breath, Visits to physicians and ER and Psychological well-being Measurements: self-administered version of the Chronic Disease Self-management questionnaire (Lorig et al. 1996) | T: Pairs of trained volunteer lay teachers. Most with chronic disease. D: Heart disease (33%), Lung disease (44%), Arthritis (54%), Stroke (11%). Also comorbidity. L: 7 times for 2.5 h, according to detailed teaching manual A: Mean 5.5 sessions G: 10–15 participants |
Kennedy et al. 2007
|
N = 629; 55 years (13.6); 30% White ethnicity from Community settings in England | RCT: intervention group and waiting list control group Pre-test and 6-month post-test | Improvement: Self-efficacy (.44), Energy (.18), Social role limitations (.19), Psychological well-being (.25), Health distress (.20), Exercise (.13), Communication with clinicians (.25). No improvement: General health, Pain, Diet, Visits medical doctor and Hospitalizations. Measurements: self-administered Chinese version of the Chronic Disease Self-management questionnaire (Lorig et al. 1996) | T: pairs of trained lay trainers and volunteer tutors D: Musculoskeletal (33.9%), Endocrine (11.7%), Circulatory (7%), Fatigue (7.5%), Respiratory (6.4%), Mental health (6%), Neurological disease (6%) and others (21.5%) L: six times for 2.5 h, according to detailed teaching manual A: ≥4 sessions G: 8–12 participants S: translated version EEP (Expert Patients Program) |
Richardson et al. 2008
| Same as Kennedy et al. 2007
| RCT: intervention group and waiting list control group Pre-test and 6 month post-test | Improvement: Self-care and Quality-adjusted life years No improvement: Mobility, Pain/Discomfort and Anxiety/Depression, Visits Medical Doctor and Hospitalizations Measurements: EQ5D (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). | Same as Kennedy et al. 2007
|
Swerissen et al. 2006
|
N = 474; 65.5 years (10); 24% People with Vietnamese, Chinese, Italian and Greek backgrounds, living in low income areas of Australia | RCT: intervention group and waiting list control group. Pre-test and 6-month post-test | Improvement: Energy, Self-rated health, Pain, Fatigue, Health distress, Self-efficacy, Exercise and Cognitive symptom management No improvement: Disability, Role function, Depression and Shortness of breath, Visits Medical Doctor and ER. Measurements: self-administered version of the Chronic Disease Self-management questionnaire (Lorig et al. 1996) | T: pairs of trained and bi-lingual peer leaders D: Arthritis (50%), High blood pressure (43%), diabetes (28%), Heart disease (14%) and Asthma (8.5%). Also comorbidity. L: six times for 2.5 h, according to detailed teaching manual A: 5.23 sessions G:10–15 participants S: translated version with minor amendments for cultural differences |
Haas et al. 2005
|
N = 109; 77.2 years (7.7); 15.6% Community-dwelling older Americans with chronic low back pain of mechanical origin | RCT: intervention group and waiting list control group. Pre-test and 6-month post-test | Improvement: Emotional well-being No improvement: Pain, Energy/fatigue, Self-efficacy, Self-care, General health and Disability. Measurements: MVK pain scale, Arthritis Self-Efficacy scale and SF-36 | T: pair of lay leaders with chronic back conditions D: chronic low back pain of mechanical origin L: six times for 2.5 h, according to detailed teaching manual. A: <3 N = 19, ≥3–5 N = 41%, 6 N = 10 G: small group format S: offering telephone support to the attendees each 2 weeks during 24 weeks |
Classification of the results
Health behaviour
Component | Improvement (+) No improvement (−) | Number of studies | Range of mean ages | Sample sizes | Follow-up (FU)a
|
---|---|---|---|---|---|
Exercise | + | 5 | 55–65.5 | 474–952 | 2–3 |
− | 1 | 68 | 139 | 1–2 | |
Healthy diet | + | 0 | |||
− | 1 | 55 | 629 | 2 | |
Tobacco | + | 1 | 57 | 551 | 3 |
− | 1 | 57 | 551 | 2 | |
Communication | + | 3 | 55–65.4 | 551–952 | 1–2 |
− | 3 | 49–68 | 139–954 | 1–2 | |
Self-care | + | 2 | 49–55 | 476–629 | 2 |
− | 1 | 77.2 | 109 | 2 |
Health status
Component | Improvement (+) No improvement (−) | Number of studies | Range of mean ages | Sample sizes | Follow-up (FU)a
|
---|---|---|---|---|---|
Pain | + | 3 | 57–65.5 | 474–954 | 2–3 |
− | 5 | 49–77.2 | 109–952 | 1–2 | |
Disability/mobility | + | 2 | 64–65.4 | 416–952 | 2 |
− | 3 | 55–77.2 | 109–629 | 2 | |
General (self-rated) health | + | 4 | 57–65.5 | 474–952 | 2 |
− | 3 | 55–77.2 | 109–629 | 1–2 | |
Health distress | + | 5 | 55–65.5 | 474–952 | 2–3 |
− | 0 | ||||
Fatigue/energy | + | 4 | 55–65.5 | 474–952 | 2 |
− | 2 | 49–77.2 | 109–476 | 2 | |
Social roles | + | 3 | 55–64 | 551–954 | 2–3 |
− | 3 | 65.4–68 | 139–952 | 1–2 | |
Discomfort | + | 0 | |||
− | 1 | 65.4 | 952 | 2 | |
Shortness of breath | + | 1 | 64 | 954 | 2 |
− | 3 | 49–65.5 | 474–952 | 2 | |
Anxiety | + | 0 | |||
− | 2 | 49–55 | 476–629 | 2 | |
Emotional, physical and psychological well-being | + | 2 | 55–77.2 | 109–629 | 2 |
− | 1 | 65.4 | 952 | 2 | |
Quality of life | + | 1 | 55 | 629 | 2 |
− | 1 | 49 | 476 | 2 | |
Depression | + | 1 | 64 | 954 | 2 |
− | 3 | 49–65.5 | 474–629 | 2 |
Well-being
Component | Improvement (+) No improvement (−) | Number of studies | Range of mean ages | Sample sizes | Follow-up (FU)a
|
---|---|---|---|---|---|
Hospitalizations | + | 1 | 65.4 | 952 | 2 |
− | 2 | 55–57 | 551–629 | 2–3 | |
Visits | + | 1 | 57 | 551 | 3 |
− | 5 | 49–65.5 | 474–952 | 2 |
Health care utilization
Self-efficacy
Component | Improvement (+) No improvement (−) | Number of studies | Range of mean ages | Sample sizes | Follow-upa
|
---|---|---|---|---|---|
Self-efficacy | + | 5 | 49–65.5 | 474–954 | 2–3 |
− | 2 | 68–77.2 | 109–139 | 1–2 | |
Mental stress management | + | 1 | 57 | 551 | 2 |
− | 0 | ||||
Cognitive symptom management | + | 3 | 50–65.5 | 474–952 | 1–2 |
− | 1 | 68 | 139 | 1–2 |