Internet-Based Chronic Disease Self-Management

TLDR

The small‑group Chronic Disease Self‑Management Program (CDSMP) has been shown to improve health‑related behaviors and health status. This study evaluated the efficacy of an Internet‑based CDSMP. A randomized controlled trial assigned 958 chronic‑disease patients to an Internet‑based CDSMP, usual care, or the small‑group CDSMP, and measured health status, behaviors, utilization, and self‑efficacy over 12 months. At 12 months the Internet‑based CDSMP produced significant health‑status improvements versus usual care, matched the small‑group CDSMP, and early self‑efficacy gains predicted better outcomes, confirming its effectiveness as a viable alternative.

Abstract

The small-group Chronic Disease Self-Management Program (CDSMP) has proven effective in changing health-related behaviors and improving health statuses. An Internet-based CDSMP was developed to reach additional chronic-disease patients.We sought to determine the efficacy of the Internet-based CDSMP.We compared randomized intervention participants with usual-care controls at 1 year. We compared intervention participants with the small-group CDSMP at 1 year.Nine-hundred fifty-eight patients with chronic diseases (heart, lung, or type 2 diabetes) and Internet and e-mail access were randomized to intervention (457) or usual care control (501).Measures included 7 health status variables (pain, shortness of breath, fatigue, illness intrusiveness, health distress, disability, and self-reported global health), 4 health behaviors (aerobic exercise, stretching and strengthening exercise, practice of stress management, and communication with physicians), 3 utilization variables (physician visits, emergency room visits, and nights in hospital), and self-efficacy.At 1 year, the intervention group had significant improvements in health statuses compared with usual care control patients. The intervention group had similar results to the small-group CDSMP participants. Change in self-efficacy at 6 months was found to be associated with better health status outcomes at 1 year.The Internet-based CDSMP proved effective in improving health statutes by 1 year and is a viable alternative to the small-group Chronic Disease Self Management Program.