A meta-analysis of health status, health behaviors, and health care utilization outcomes of the Chronic Disease Self-Management Program

• Published in: Preventing chronic disease 2013-01, Vol.10, p.120112-120112, Article 120112
• Main Authors: Brady, Teresa J, Murphy, Louise, O'Colmain, Benita J, Beauchesne, Danielle, Daniels, Brandy, Greenberg, Michael, House, Marnie, Chervin, Doryn
• Format: Article
• Language: English
• Subjects: Chronic Disease - psychology; Chronic Disease - therapy; Female; Health Behavior; Health Services - statistics & numerical data; Health Status; Humans; Male; Outcome and Process Assessment (Health Care) - methods; Patient Education as Topic; Program Evaluation; Randomized Controlled Trials as Topic; Reviews; Self Care - methods
• ISSN: 1545-1151; 1545-1151
• DOI: 10.5888/pcd10.120112

The Chronic Disease Self-Management Program (CDSMP) is a community-based self-management education program designed to help participants gain confidence (self-efficacy) and skills to better manage their chronic conditions; it has been implemented worldwide. The objective of this meta-analysis was to quantitatively synthesize the results of CDSMP studies conducted in English-speaking countries to determine the program's effects on health behaviors, physical and psychological health status, and health care utilization at 4 to 6 months and 9 to 12 months after baseline. We searched 8 electronic databases to identify CDSMP-relevant literature published from January 1, 1999, through September 30, 2009; experts identified additional unpublished studies. We combined the results of all eligible studies to calculate pooled effect sizes. We included 23 studies. Eighteen studies presented data on small English-speaking groups; we conducted 1 meta-analysis on these studies and a separate analysis on results by other delivery modes. Among health behaviors for small English-speaking groups, aerobic exercise, cognitive symptom management, and communication with physician improved significantly at 4- to 6-month follow-up; aerobic exercise and cognitive symptom management remained significantly improved at 9 to 12 months. Stretching/strengthening exercise improved significantly at 9 to 12 months. All measures of psychological health improved significantly at 4 to 6 months and 9 to 12 months. Energy, fatigue, and self-rated health showed small but significant improvements at 4 to 6 months but not at 9 to 12 months. The only significant change in health care utilization was a small improvement in the number of hospitalization days or nights at 4 to 6 months Small to moderate improvements in psychological health and selected health behaviors that remain after 12 months suggest that CDSMP delivered in small English-speaking groups produces health benefits for participants and would be a valuable part of comprehensive chronic disease management strategy.