Impact of a chronic disease self-management program on healthcare utilization in eastern Ontario, Canada

ObjectivesThe Chronic Disease Self-Management Program (CDSMP) is a standardized self-management intervention for patients with various chronic diseases. CDSMP provides self-management skills to enhance patient health, well-being, and coping skills. The present study evaluates the effectiveness of CDSMP delivered in routine clinical services on health, health behaviors and healthcare utilization in patients with various chronic illnesses.MethodsA pragmatic single group pre-post design evaluated the effectiveness of the CDSMP in an Irish cohort using self-report data collected by service providers in hospital, community health and patient organizations. Data on health, health behavior and healthcare utilization were collected at baseline ( n = 263), immediately post-program ( n = 102), and six months ( n = 81) after enrollment.ResultsCDSMP participants reported statistically significant increases in activity levels, self-efficacy, energy and quality of life, and a significant decrease in depression scores at six months follow-up. There was a significant decrease in self-reported visits to the GP and in total nights spent in hospital.DiscussionThis national pre–post study provides preliminary evidence for the potential effectiveness of CDSMP delivered during routine care in improving important health outcomes and reducing health care utilization among a heterogeneous sample of chronic disease patients.

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Harvest Health: A Chronic Disease Self-Management Program

PsycEXTRA Dataset ◽

10.1037/e515812006-002 ◽

2005 ◽

Keyword(s):

Chronic Disease ◽

Management Program ◽

Self Management

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A Meta-Analysis of Health Status, Health Behaviors, and Health Care Utilization Outcomes of the Chronic Disease Self-Management Program

Preventing Chronic Disease ◽

10.5888/pcd10.120112 ◽

2013 ◽

Vol 10 ◽

Cited By ~ 134

Author(s):

Teresa J. Brady ◽

Louise Murphy ◽

Benita J. O’Colmain ◽

Danielle Beauchesne ◽

Brandy Daniels ◽

...

Keyword(s):

Health Care ◽

Chronic Disease ◽

Health Status ◽

Health Care Utilization ◽

Health Behaviors ◽

Meta Analysis ◽

Management Program ◽

Self Management ◽

Care Utilization

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Implementation and evaluation of the chronic-disease self-management program among Chinese immigrant older adults in the U.S.

Geriatric Nursing ◽

10.1016/j.gerinurse.2014.07.002 ◽

2014 ◽

Vol 35 (6) ◽

pp. 448-450 ◽

Cited By ~ 5

Author(s):

XiaoRong Wang ◽

Heather K. Hardin ◽

Lei Zhou ◽

Lei Fang ◽

Pan Shi ◽

...

Keyword(s):

Older Adults ◽

Chronic Disease ◽

Management Program ◽

Self Management ◽

Chinese Immigrant ◽

The U.S

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Standardising the Lay: Logics of Change in Programs of Disease Self-management

Culture Unbound Journal of Current Cultural Research ◽

10.3384/cu.2000.1525.124425 ◽

2012 ◽

Vol 4 (3) ◽

pp. 425-442 ◽

Cited By ~ 9

Author(s):

Annegrete Juul Nielsen ◽

Lone Grøn

Keyword(s):

Chronic Disease ◽

Role Models ◽

Chronic Condition ◽

Expert Knowledge ◽

Management Program ◽

The Self ◽

Self Management ◽

Social Settings ◽

Patient Centric ◽

Forms Of Knowledge

The health political discourse on self-care is dominated by the view that the selfmanaging patient represents a more democratic and patient-centric perspective, as he or she is believed to renegotiate the terms on which patient participation in health care has hitherto taken place. The self-managing patient is intended as a challenge to traditional medical authority by introducing lay methods of knowing disease. Rather than a meeting between authoritative professionals and vulnerable patients, the self-managing patient seeks to open up new spaces for a meeting between experts. The present paper questions these assumptions through an ethnographic exploration of a patient-led self-management program called the Chronic Disease Self-Management Program. The program is concerned with what its developers call the social and mental aspects of living with a chronic disease and uses trained patients as role models and program leaders. Drawing inspiration from Annemarie Mol’s term ’logic’, we explore the rationale of ’situations of selfmanagement’ and identify what we call a ’logic of change’, which involves very specific ideas on how life with a chronic condition should be dealt with and directs attention towards particular manageable aspects of life with a chronic condition. This logic of change entails, we argue, a clash not between ’medical’ and ’lay’ forms of knowledge but between different logics or perceptions of how transformation can be achieved: through open-ended and ongoing reflection and experimentation in social settings or through standardised trajectories of change. Returning to the literature on lay forms of knowledge and illness perspectives, we question whether programs such as the Chronic Disease Self-Management Program – despite its apparent patient-centric perspective – reproduces classical hierarchical relations between lay and expert knowledge, albeit in new forms.

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