Skip to main content

Table 1 Summary of included trials

From: Patient engagement as a risk factor in personalized health care: a systematic review of the literature on chronic disease

Study (year) Disease or condition N Mean age (SD) Sex Intervention Control Intervention length Follow up Results*
Barlow et al. (2009)[31] MS 216 I = 48.2 (10.1) 59 M In-person group-based chronic disease self-management program Wait-list control + comparison group 6 weeks (2 h/week) 4, 12 months 0 Self-management self-efficacy (P = 0.132, ES = 0.30)
C = 50.7 (11.7) + MSIS physical status (P = 0.005, ES = 0.21)
Comparison = 54.6 (10.8) 0 Improvement in depression (P = 0.632)
0 MS self-efficacy (P = 0.161)
0 cognitive symptom management (P = 0.140)
0 MD communication (P = 0.861)
Glasgow et al. (2012)[32] Diabetes 463 I (CASM+) = 57.8 (9.3) 232 M Internet-based diabetes self-management program with (CASM+) and without enhanced social support (CASM) Enhanced usual care (computer-based health risk appraisal feedback with recommendations for preventive behaviors) 12 months (ongoing internet-based intervention); CASM + group also received three 120-minute group sessions and two follow-up calls 4, 12 months + Health behaviors (eating habits, fat intake, physical activity: P < 0.05, ES = 0.09-0.16)
I (CASM) = 58.7 (9.3) + Biological outcomes (lower HbA1c, improved lipid ratio, BP MAP, 10-year CHD risk: P < 0.05)
C = 58.7 (9.1) + Psychosocial and QOL measures (self-efficacy, problem solving, general health state, diabetes distress: P < 0.05)
0 Medication adherence
Goeppinger et al. (2007)[33] Arthritis 416 I = 64 (12.78) 75 M Arthritis self-help group: small group, in-person workshops specific to arthritis Generic chronic disease self-management group: small group, in-person workshops not specific to arthritis 6 weekly sessions 2–2.5 h each 4, 12 months + Self-efficacy (P = 0.004)
C = 64 (12.8)
+ General health (P = 0.016)
+ Stretching minutes (P = 0.023)
+ Strengthening minutes (P = 0.016)
Hibbard et al. (2007)[34] At least one of six chronic diseases (T2D, HTN, arthritis, CHD, COPD, hyperlipidemia) 479 I = 59.6 147 M In-person group-based chronic disease self-management program No intervention 6 weeks 6 months 0 Engagement (PAM) (P < 0.001)
C = 60.0 (2.5 h/1 wk)
+ General self-management behaviors (P < 0.05)
+Diabetes self-management behaviors (P < 0.05)
+Arthritis self-management behaviors (P < 0.05)
+ HRQoL (P = NR)
Huang et al. (2009)[35] Asthma 148 I = NR 108 M Individualized self-care education program, with and without peak flow monitoring (PFM) Usual care 6 months 1, 6 months + Asthma self-care competence (P < 0.001)
I + PFM = NR + Asthma self-care behaviors (P < 0.001)
C = NR Asthma self efficacy (P < 0.001)
0 Unscheduled health service usage
Lavery et al. (2011)[36] Bronchiectasis 64 I = 60 (9) 29 M In-person, group-based patient self-management program Usual care 8 weeks (2.5 h/week) 3, 6 months + Self-efficacy in exercise (P = 0.02); to get information about disease (P = 0.03); to manage disease in general (P = 0.05); to do chores (P = 0.04); for social/recreational activities (P = 0.03); to manage symptoms (P < 0.01); to control/manage depression (P = 0.01)
0 Self-efficacy in obtaining help from community, family and friends (P = 0.06); communicate with physician (P = 0.85); to manage shortness of breath (P = 0.08)
+ Symptom reporting (P < 0.05)
+ Decreased QOL (P = 0.01)
+ Increase in self-reported health care use (P < 0.05)
0 IPQ-R score
0 Lung function
C = 60 (8)
Lorig et al. (2010)[37] Diabetes 761 All = 54.3 206 M Internet-based diabetes self-management program Usual care 6 weeks 6, 18 months + Engagement (PAM) (P = 0.021)
+ Self-efficacy (P < 0/001)
+ Lower HbA1C (P < 0.05; ES = 0.111)
+ Lower HbA1C high subgroup baseline ≥7.0 (P = 0.01; ES = 0.499)
0 Health behavior and utilization
0 Exercise (P = 0.810)
Lorig et al. (2009)[38] Diabetes 345 I = 67.7 (11.9) 124 M Community-based, peer-led diabetes self-management program Usual care 6 weeks 6, 12 months + Engagement (PAM) (P = 0.017)
(2.5 h/1 wk)
C = 65.4 (11.4) + Self-efficacy (P = 0.001)
  0 Lower HbA1C
+ Hypoglycemia symptoms (P = 0.002; ES > 0.30)
0 Hyperglycemia symptoms
+ Healthy eating (P < 0.001; ES > 0.30)
+ Lower depression (P < 0.001)
+ Communication with providers (P = 0.016)
Moriyama et al. (2009)[39] Diabetes 75 I = 66.4 (9.2) 30 M In person, individual self-management education program Usual care 12 months 3, 6, 9, 12 months + Lower body weight (P = 0.001)
+ Lower HbA1C (P = 0.049)
+ Self-efficacy (P = 0.001)
+ Dietary and exercise stages (P = 0.017 and P = 0.020)
+ Degree of goal attainment (P = NR)
+ QOL (P = 0.055)
+ Lower diastolic BP (P = 0.067)
+ Lower total cholesterol (P = 0.087)
C = 65.2 (8.5)
Wolever et al. (2010)[40] Diabetes 56 I = 53.1 (8.29) 13 M Integrative health coaching Wait-list control 6 months 1 month + Engagement (PAM) (P < 0.001)
C = 52.8 (7.64) (14 sessions, 0.5 h each) + Medication adherence (P < 0.005)
+ Perception of illness (P < 0.05)
+ Psychosocial health (P < 0.05)
0 Lower HbA1C (all subjects)
          + Lower HbA1C for high subgroup baseline >7.0 (P = 0.016; ES = 0.34)
  1. BP, blood pressure; BP MAP, blood pressure mean arterial pressure; C, control; CASM, computer-assisted self-monitoring; CHD, chronic heart disease; COPD, chronic obstructive pulmonary disease; ES, effect size; HRQOL, health-related quality of life; HTN, hypertension; I, intervention; IPQ-R, Illness Perception Questionnaire-Revised; M, male; MS, multiple sclerosis; MSIS, Multiple Sclerosis Impact Scale; NR, not reported; PAM, Patient Activation Measure; PFM, peak flow monitoring; QOL, quality of life; SD, standard deviation; T2D, type 2 diabetes.