Joshua Chodosh, MD, MSHS; Sally C. Morton, PhD; Walter Mojica, MD, MPH; Margaret Maglione, MPP; Marika J. Suttorp, MS; Lara Hilton, BA; Shannon Rhodes, MFA; Paul Shekelle, MD, PhD
Acknowledgments: The authors thank Daniel H. Solomon, MD, for providing his list of chronic disease self-management articles.
Grant Support: By a Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services, grant to RAND Health, 500-98-0281. Dr. Chodosh is a Veterans Affairs Health Services Research and Development Career Development awardee. Dr. Shekelle was a senior research associate of the Veterans Affairs Health Services Research and Development Service during the time of this study.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Joshua Chodosh, MD, MSHS, Greater Los Angeles Veterans Affairs Healthcare System, GRECC (11G), 11301 Wilshire Boulevard, Los Angeles, CA 90073.
Current Author Addresses: Dr. Chodosh: Greater Los Angeles Veterans Affairs Healthcare System, GRECC (11G), 11301 Wilshire Boulevard, Los Angeles, CA 90073.
Dr. Morton: RTI International, 3040 Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709-2194.
Dr. Mojica, Ms. Maglione, Ms. Suttorp, Ms. Hilton, and Ms. Rhodes: RAND Corporation, 1776 Main Street, Santa Monica, CA 90401.
Dr. Shekelle: Greater Los Angeles Veterans Affairs Healthcare System, General Medicine (111G), 11301 Wilshire Boulevard, Los Angeles, CA 90401.
Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L, et al. Meta-Analysis: Chronic Disease Self-Management Programs for Older Adults. Ann Intern Med. 2005;143:427-438. doi: 10.7326/0003-4819-143-6-200509200-00007
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Published: Ann Intern Med. 2005;143(6):427-438.
Do self-management programs improve outcomes of adults with chronic conditions?
This meta-analysis summarizes data from 53 randomized, controlled trials of self-management interventions for adults with diabetes mellitus, hypertension, or osteoarthritis. Self-management helped reduce hemoglobin A1c and blood pressure levels in diabetes and hypertension, respectively, but had minimal effect on pain and function in patients with arthritis. The authors could not identify any self-management program characteristics that predicted successful outcomes.
The authors found evidence of possible publication bias.
Self-management programs may improve some outcomes in patients with some chronic diseases, but how to design an optimal program is not yet clear.
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Cardiology, Endocrine and Metabolism, Geriatric Medicine, Nephrology, Rheumatology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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