Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization - A randomized trial

OBJECTIVES. This study evaluated the effectiveness (changes in health behav iors, health status, and health service utilization) of a self-management p rogram for chronic disease designed for use with a heterogeneous group of c hronic disease patients. It also explored the differential effectiveness of the intervention for subjects with specific diseases and comorbidities. METHODS. The study was a six-month randomized, controlled trial at communit y-based sites comparing treatment subjects with wait-list control subjects. Participants were 952 patients 40 years of age or older with a physician-c onfirmed diagnosis of heart disease, lung disease, stroke, or arthritis. He alth behaviors, health status, and health service utilization, as determine d by mailed, self-administered questionnaires, were measured. RESULTS. Treatment subjects, when compared with control subjects, demonstra ted improvements at 6 months in weekly minutes of exercise, frequency of co gnitive symptom management, communication with physicians, self-reported he alth, health distress, fatigue, disability, and social/role activities limi tations. They also had fewer hospitalizations and days in the hospital. No differences were found in pain/physical discomfort, shortness of breath, or psychological well-being. CONCLUSIONS. An intervention designed specifically to meet the needs of a h eterogeneous group of chronic disease patients, including those with comorb id conditions, was feasible and beneficial beyond usual care in terms of im proved health behaviors and health status. It also resulted in fewer hospit alizations and days of hospitalization.