Chronic Disease Self-Management Program

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Self-Management Research
Chronic Disease Self-Management Program

The Chronic Disease Self-Management Program (called the Chronic Conditions Self-Management Program at Self-Management BC) is a lay-led patient education program. This program is led by pairs of trained lay leaders to groups of ten to sixteen people once each week for 2 and ½ hours for six consecutive weeks. Courses are held in community locations such as recreation centres, community centres, schools and churches. Workshops are facilitated by two trained leaders, one or both of whom are non-health professionals with a chronic diseases themselves.

The program includes the following topics:
  • how to develop a suitable exercise program;
  • cognitive symptom management;
  • healthy eating;
  • breathing exercises;
  • problem solving;
  • communication skills with family, friends and health care providers;
  • use of medication;
  • and how to deal with emotions of chronic illness (anger and depression).
Each participant in the workshop receives a copy of the companion book, Living a Healthy Life with Chronic Conditions, 4th Edition. It is the process in which the program is taught that makes it effective. Classes are highly participative, where mutual support and success build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.

The Chronic Disease Self-Management Program will not conflict with existing programs or treatment. It is designed to enhance regular treatment and disease-specific education such as cardiac rehabilitation or diabetes instruction. In addition, many people have more than one chronic condition. The program is especially helpful for these people, as it gives them the skills to coordinate all the things needed to manage their health, as well as to help them keep active in their lives.
Course participants include persons living with chronic health conditions, as well as their family, friends and caregivers. The program is available in select communities in Punjabi, Cantonese and Mandarin languages. Participants must be able to function in a group setting and set goals.

Program participants are self-referred. Recruitment strategies include a website and toll-free line, brochures, flyers, and posters, newspaper and television advertisements, and presentations to the public.

Program Manuals

The Chronic Disease Self-Management Program is a standardized program with program manuals for Leaders (facilitators of the six-session workshop), Master Trainers (trainers of leaders), and T-Trainers (trainers of Master Trainers).

Fidelity Standards for Training and Implementation
The Chronic Disease Self-Management Program follows a structured implementation and intervention model. The evidence-based self management programs previously offered by the Stanford Patient Education Research Center have moved to the Self-Management Resource Center. In 2016, the SMRC published a “Program Fidelity Manual” and “Administration/Implementation Manual” for trainers and administrators. The program is copyrighted by the Self-Management Resource Center (SMRC) and each organization wishing to implement the Chronic Disease Self-Management Program applies and purchases a license from SMRC. A contract is developed and licensees are obligated to deliver the program in the specified manner with no modifications or additions. For more information, please visit the SMRC website at www.selfmanagementresource.com.

Program’s Evaluation History
- US Centers for Disease Control and Prevention. (in press). Sorting Through the Evidence for the Arthritis Self-Management Program and the Chronic Disease Self-Management Program.
  • US Centers for Disease Control and Prevention. (2011). Sorting Through the Evidence for the Arthritis Self-Management Program and the Chronic Disease Self-Management Program. 
  • National Health Service. (Feb 1, 2010). Expert Patients Programme: Self care reduces costs and improves health – the evidence.
  • Richardson G, Kennedy A, Reeves D, Bower P, Lee V, Middleton E, Gardner C, Gately C and Rogers A. Cost Effectiveness of the Expert Patients Programme (EPP) for Patients with Chronic Conditions. Journal of Epidemiology and Community Health, 62:361-367, 2008
  • Gordon C and Galloway T. Review of Findings on Chronic Disease Self-Management Program (CDSMP) Outcomes: Physical, Emotional & Health-Related Quality of Life, Healthcare Utilization and Costs. Centers for Disease Control and Prevention and National Council on Aging, 2008.
  • Kennedy A, Reeves D, Bower P, Lee V, Middleton E, Richardson G, Gardner C, Gately C, Rogers A. The Effectiveness and Cost Effectiveness of a National Lay-led Self Care Support Programme for Patients with Long-term Conditions: A Pragmatic Randomised Controlled Trial. Journal of Epidemiology and Community Health, 61(3), 254-61, 2007
  • McGowan P. The Diabetes Self-Management Program in British Columbia Project Evaluation. Report submitted to The Canadian Diabetes Strategy Prevention and Promotion Contribution Program, May, 2004
  • Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M. Effect of a Self-Management Program on Patients with Chronic Disease. Effective Clinical Practice, 4(6), 256-262, 2001
  • Lorig KR, Ritter PL, Stewart AL, Sobel DS, Brown BW, Bandura A, González VM, Laurent DD, Holman HR. Chronic Disease Self-Management Program: 2-Year Health Status and Health Care Utilization Outcomes. Medical Care, 39(11),1217-1223, 2001
  • Lorig KR, Sobel DS, Stewart AL, Brown Jr BW, Ritter PL, González VM, Laurent DD, Holman HR. Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization and costs: A randomized trial. Medical Care, 37(1):5-14, 1999