Table 1 Summary of included trials
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) |
(2.5Â h/1 wk) | |||||||||
C = 65.4 (11.4) | + Self-efficacy (P = 0.001) | ||||||||
| Â | 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) |