Evidence-Based Outcomes of Stanford University’s Chronic Disease Self-Management Program (CDSMP – “Living Well with Chronic Conditions” in Wisconsin) and Diabetes Self-Management Program (DSMP – “Healthy Living with Diabetes” in Wisconsin)
· Reduces healthcare expenditures:
o In four studies there were fewer emergency department visits
o In three studies there were fewer hospitalizations
o In four studies there were fewer days in the hospital
o In two studies there were reductions in outpatient visits
Health care utilization reduced over period, netting $390-$520 savings per participant less physician visits: -0.10; ER visits: -0.15; Other health visits: -0/10; Nights in hospital: -0.70
· Results in more appropriate utilization of health care resources, addressing healthcare needs in outpatient settings rather than ER visits and hospitalizations.
· Health outcomes include:
o Measurable and positive effect on physical and emotional outcomes and health-related quality of life
o Greater self-efficacy
o Improvement in cognitive symptom management
o Greater energy/reduced fatigue of participants
o Increased physical activities and maintains the activity over time
o Fewer social role limitations
o Lower health distress
o Better psychological well-being; decrease in depression
o Enhanced communication skills between patients and physicians and other clinicians
· Effective across chronic diseases.
· Benefits across the spectrum of socioeconomic and educational levels, among various ethnic groups
· Enables participants to manage progressive, debilitating illness; Program participants do not experience greater healthcare utilization, even when their disability worsens.
· Health benefits persist over time.
o Participants maintain many of their health and behavioral improvements over time.
o Significant improvements in exercise and social/role limitations seen over a two-year period.
Centers for Disease Control & Prevention (CDC) review of 13 CDSMP studies. Analysis was conducted on 8 studies that contained sufficient utilization data. Six studies were domestic and two were from the UK. Two of the six domestic studies targeted Spanish-speaking Hispanics. Participants were generally 40+ years of age. Sample sizes ranged from a low of 171 to a high of 1,140 with a mean of 682.
· Compared to control group, participants of the self-management programs of CDSMP and DSMP were more likely to lose 10% of their body weight.
· Compared to control group, participants of the self-management programs of CDSMP and DSMP were more likely to demonstrate a lower A1C over time.
Alaska Section of Chronic Disease Prevention and Health Promotion. Clinical Outcomes of Urban Community Health Center Patients Who Participated in Self-Management Classes. Volume 5, Issue 2, July 2013, by Barbara Stillwater PhD, RN and Clint Farr MS, Alaska Diabetes Prevention and Control Program