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Effect of Changes in Patient’s Self-management Strategies on Clinical Outcomes: Evidence from a Cohort Study of Patients with Diabetes, Hypertension, and Hyperlipidemia

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Abstract

Background

Self-management has become the dominant care model for chronic disease management. This study aimed to investigate the effect of changes in self-management strategies on the clinical outcomes of chronic diseases.

Methods

Two hundred ninety-seven patients with one or more chronic disease (diabetes, dyslipidemia, or hypertension) were registered and followed in this prospective cohort study. We compared differences in the changes in clinical outcomes from baseline to 6 months according to the improvement of self-management strategies by analysis of covariance.

Results

Diabetic patients with improved self-management strategies showed a significantly greater change in HbA1c levels compared to patients without improvement of self-management strategies (group difference in HbA1c = 0.51%). In hypertensive patients, systolic and diastolic blood pressure (BP) showed a significant decline in the patients with improved self-management strategies (group difference in systolic BP = 6.2 mmHg and in diastolic BP = 5.5 mmHg). Clinical outcomes improved significantly when self-management strategies improved in people with a poor self-management strategy at baseline.

Conclusions

This study suggests that improvements in self-management strategies are associated with an improvement in clinical outcomes among patients with chronic diseases, especially for those with an initially poor self-management strategy.

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Abbreviations

SAT-SF:

Smart Management Strategy for Health Assessment Tool Short Form

SAT-C:

Self-management strategies—core strategies

SAT-P:

Self-management strategies—preparation strategies

SAT-I:

Self-management strategies—implementation strategies

HbA1c:

Glycated hemoglobin

FBS:

Fasting blood glucose

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

TC:

Total cholesterol

LDL-C:

Low-density lipoprotein cholesterol

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Funding

This study was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, and funded by the Ministry of Health & Welfare, Republic of Korea (grant number HI16C0455). The funding organization did not have any role in the design of the study, analysis and interpretation of the data, or preparation, review, and approval of the manuscript.

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Author notes

  1. EunKyo Kang and Kyae Hyung Kim contributed equally to this work as first authors.

Authors and Affiliations

  1. Public Healthcare Center, Seoul National University Hospital, Seoul, Korea

    EunKyo Kang & Kyae Hyung Kim

  2. Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 103 Daehak-ro Jongno-gu, Seoul, 03080, Korea

    EunKyo Kang, Kyae Hyung Kim, Sang Min Park & Young Ho Yun

  3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Young Min Cho, Yong-Jin Kim & Hae-Young Lee

  4. Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea

    Ye Eun Rhee, Soojeong Kim & Young Ho Yun

Authors
  1. EunKyo Kang
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  2. Kyae Hyung Kim
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  3. Young Min Cho
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Corresponding author

Correspondence to Young Ho Yun.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Institutional Review Board of Seoul National University Hospital approved this study (IRB No. H-1512-131-731).

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Kang, E., Kim, K.H., Cho, Y.M. et al. Effect of Changes in Patient’s Self-management Strategies on Clinical Outcomes: Evidence from a Cohort Study of Patients with Diabetes, Hypertension, and Hyperlipidemia. Int.J. Behav. Med. 28, 479–487 (2021). https://doi.org/10.1007/s12529-020-09937-x

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