Internet-based chronic disease self-management: a randomized trial

Med Care. 2006 Nov;44(11):964-71. doi: 10.1097/01.mlr.0000233678.80203.c1.

Abstract

Background: 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.

Objectives: We sought to determine the efficacy of the Internet-based CDSMP.

Design: We compared randomized intervention participants with usual-care controls at 1 year. We compared intervention participants with the small-group CDSMP at 1 year.

Subjects: 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: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease / therapy*
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Health Status Indicators
  • Humans
  • Internet / statistics & numerical data*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Self Care*
  • Self Efficacy*
  • Surveys and Questionnaires
  • Time Factors