A systematic review of outcomes of chronic disease self-management interventions
- 2.9k Downloads
To carry out a systematic review of program outcomes used in the evaluation of group-based self-management interventions aimed at people with arthritis and other chronic conditions.
The systematic search was performed across databases MEDLINE, EMBASE, CINAHL, and PsycINFO. Both between-group and within-group effect sizes (ES) were calculated. Results were interpreted as small (ES ~ 0.2), medium (ES ~ 0.5), or large (ES ~ 0.8) effects.
The majority of 18 included trials investigated the effectiveness of arthritis-specific interventions. Across most outcomes, small effects on course participants were shown. While effects on knowledge were large (between-group ES = 0.78), effects on clinical outcomes such as pain (ES = 0.10) were negligible to small.
This paper is consistent with other reviews in this area, suggesting that people with arthritis receive only marginal benefits from participating in chronic disease self-management interventions. When looking at the types of outcomes that trials are based on, however, alternative explanations for these results seem probable. As evaluations heavily rely on patient self-report, current approaches to program evaluation may not be sufficient to assess the intended impact of self-management education. An in-depth investigation of the types of outcomes assessed is provided in a separate paper.
KeywordsSystematic review Chronic disease Self-management Patient education Program evaluation Outcomes assessment
- 15.Stanford Patient Education Research Center. (2012). Organizations Licensed to Offer the Chronic Disease Self-Management Program. Retrieved 04.09.2012, from http://patienteducation.stanford.edu/organ/cdsites.html#aus.
- 16.Lorig, K. R., González, V. M., & Laurent, D. D. (1999). The Chronic Disease Self-Management Program: Leaders Manual. Palo Alto: Stanford University.Google Scholar
- 21.Lorig, K. R. (1982). Arthritis self-management: A patient education program. Rehabilitation Nursing, 8, 16–20.Google Scholar
- 22.Sackett, D. L. (1994). The cochrane collaboration. ACP Journal Club, 120(Suppl 3), A-11.Google Scholar
- 25.The Cochrane Collaboration. (2007). Cochrane reviews. Retrieved 03.01.2007, from http://www.cochrane.org/reviews/.
- 26.Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
- 28.Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. San Diego, CA: Academic Press.Google Scholar
- 34.Solomon, D. H., Warsi, A., Brown-Stevenson, T., Farrell, M., Gauthier, S., Mikels, D., et al. (2002). Does self-management education benefit all populations with arthritis? A randomized controlled trial in a primary care physician network. Journal of Rheumatology, 29(2), 362–368.PubMedGoogle Scholar
- 35.Swerissen, H., Belfrage, J., Weeks, A., Jordan, L., Walker, C., Furler, J., et al. (2006). A randomised control trial of a self-management program for people with a chronic illness from Vietnamese, Chinese, Italian and Greek backgrounds. Patient Education and Counseling, 64(1–3), 360–368.PubMedCrossRefGoogle Scholar
- 36.Worth, H. (2002). Effects of patient education in asthma and COPD—What is provable? Medizinische Klinik, 97(2, Suppl), 20–24.Google Scholar
- 40.Barlow, J. H., Turner, A. P., & Wright, C. C. (2000). A randomized controlled study of the Arthritis Self-Management Programme in the UK. Health Education Research, 15(6), 665–680.Google Scholar
- 46.Haas, M., Groupp, E., Muench, J., Kraemer, D., Brummel-Smith, K., Sharma, R., et al. (2005). Chronic disease self-management program for low back pain in the elderly. Journal of Manipulative and Physiological Therapeutics, 28(4), 228–237.Google Scholar
- 52.Osborne, R. H., Elsworth, G. R., & Whitfield, K. (2007). The Health Education Impact Questionnaire (HEIQ): An outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions. Patient Education and Counseling, 66, 192–201.Google Scholar
- 54.Schwartz, C. E., & Rapkin, B. D. (2004). Reconsidering the psychometrics of quality of life assessment in light of response shift and appraisal. Health qual life outcomes retrieved April 15, 2006, from http://www.hqlo.com/content/2/1/16.
- 55.Osborne, R. H., Batterham, R., & Livingston, J. (2011). The evaluation of chronic disease self-management support across settings: The international experience of the health education impact questionnaire monitoring system. Nursing Clinics of North America, 46(3), 255–270.PubMedCrossRefGoogle Scholar