Appendix B: Final Literature Review—Appendix A. Articles Included in Review of the Literature Table

Design and Evaluation of Three Administration on Aging (AoA) Programs: Chronic Disease Self-Management Program Evaluation Design—Final Evaluation Design Report (continued)

Article #	Country Code	Citation	Study Design	Program	Mode of Intervention	Sample Characteristics	Data Collection	Key Findings
1	USA	Ahmed, T., & Villagra, V. (2006). Disease management programs: program intervention, behavior modification, and dosage effect. [Article]. Journal of Consumer Policy, 29(3), 263-278.	Pre-post design; matched concurrent comparison	Diabetes Disease Management Program (DDMP)	Telephone-based	Diabetes-specific: Pre-post, n = 43,492; Matched group, n = 39,292	Administrative records review	Patients with access to DDMP experience better quality of care as indicated by HEDIS measures. Longer participation is also associated with incremental improvements in HEDIS metrics in four of six indicators, arguing for interventions that last at least six months. The study also suggests that overall cost of care can be reduced for managed care plan members who participate in DDMP programs, although increases in pharmacy and other services occurred.
2	UK	Armstrong, N., & Powell, J. (2008). Preliminary test of an Internet-based diabetes self-management tool. [Article]. Journal of Telemedicine & Telecare, 14(3), 114-116.	Focus group	Virtual Clinic for diabetes self-management	Internet-based	Diabetes-specific, N=5	Focus group	Including a variety of information sources and effectively organizing content may be important keys to success for internet-based diabetes self-management programs.
3	UK	Barlow, J., Turner, A., Edwards, R., & Gilchrist, M. (2009). A randomised controlled trial of lay-led self-management for people with multiple sclerosis. [Article]. Patient Education & Counseling, 77(1), 81-89.	RCT	CDSMP	Community-based	Multiple sclerosis-specific: Treatment, n = 78; Wait-list control, n = 64; Comparison, n = 74	Mailed questionnaires	CDSMP had a significant impact on self-efficacy and physical status, with trend towards improvement in depression.
4	UK	Barlow, J., Wright, C. C., Turner, A. P., & Bancroft, G. V. (2005). A 12-month follow-up study of self-management training for people with chronic disease: are changes maintained over time? British Journal Of Health Psychology, 10(Pt 4), 589-599.	Pre-post design	CDSMP	Community-based	n = 171	Mailed questionnaires; Telephone follow-up with subsample	Significant improvements were found from baseline to 4-month follow-up on self-efficacy, cognitive symptom management, physician communication, fatigue, anxious and depressed mood, and health distress. No significant changes were found between 4- and 12-month follow-ups osuggesting that the improvements noted on these variables at 4-months were maintained in the longer-term.
5	Australia	Battersby, M., Hoffmann, S., Cadilhac, D., Osborne, R., Lalor, E., & Lindley, R. (2009). ‘Getting your life back on track after stroke’: a Phase II multi-centered, single-blind, randomized, controlled trial of the Stroke Self-Management Program vs. the Stanford Chronic Condition Self-Management Program or standard care in. [Article]. International Journal of Stroke, 4(2), 137-144.	RCT protocol report	CDSMP and Stroke Self-Management Program	Community-based	Stroke-survivorship	Mailed questionnaires	None to report. Publication describes RCT design protocol.
6	Australia	Beckmann, K., Strassnick, K., Abel, L., Hermann, J., & Oakley, B. (2007). Is a Chronic Disease Self-Management Program Beneficial to People Affected by Cancer? [Article]. Australian Journal of Primary Health, 13(1), 36-44.	Qualitative interview	CDSMP and Cancer Self-Management Program	Community-based	Cancer-survivorship: Generic CDSMP, n = 10; Cancer-specific, n = 25	Telephone interviews	This study suggests the CDSMP is an acceptable model for people affected by cancer (patients and caregivers) to help them manage psychological and physical impacts of having had cancer. Findings suggest a disease-specific model is preferable to a generic model, and also suggest that information targeted to carers may need to be further developed to meet their needs.
7	USA	Bedell, G. (2008). Balancing health, work, and daily life: Design and evaluation of a pilot intervention for persons with HIV/AIDS. [Article]. Work, 31(2), 131-144.	Pre-post design	Self-management and work skills for persons with HIV/AIDS	Community-based	HIV/AIDS-specific, n = 53	In-person and telephone interviews	Findings suggest that an HIV/AIDS-specific intervention geared toward self-management and work transition skills is positively associated with percieved ability to work, and may also be associated with improvements in health and work outcomes.
8	n/a	Chodosh, J., Morton, S. C., Mojica, W., Maglione, M., Suttorp, M. J., Hilton, L., et al. (2005). Chronic Disease Self-Management Programs for Older Adults. [Article]. Annals of Internal Medicine, 143(6), I32-I32.	Meta-analysis	CDSMP and other self-management programs targeting chronic conditions	n/a	53 studies included in the analysis	n/a	This meta-analysis suggests that diabetes mellitus and hypertension specifc self management programs are likely to yield beneficial effects. This does not appear to be true for osteoarthiritis specific programs. The study could not determine the most essential components of a self-management program, although findings suggest that providing feedback to participants might be an important component.
9	Australia	Cummings, E., & Turner, P. (2009). Patient self-management and chronic illness: evaluating outcomes and impacts of information technology. Studies In Health Technology And Informatics, 143, 229-234.	Mixed methods design with a subsample of an RCT	COPD self-management program	Telephone-based	COPD-specific, n = 12	Diary-keeping and questionnaire	Participants who did not utilize the information-technology (IT) component of the study reported greater improvements than IT users; IT users were also found to have an increase of depression.
10	USA	Damush, T. M., Jackson, G. L., Powers, B. J., Bosworth, H. B., Cheng, E., Anderson, J., et al. (2010). Implementing Evidence-Based Patient Self-Management Programs in the Veterans Health Administration: Perspectives on Delivery System Design Considerations. [Article]. JGIM: Journal of General Internal Medicine, 25, 68-71.	Implementation report	Hypertension and stroke self-management programs	n/a	Hyptertension and/or strokesurvivorship	n/a	Benefits of self-management programs may extend beyond the disease/condition of interest; e.g., a hypertension program also helped participants improve glycemic control Leadership and support tools are important components of an intervention that may influence its success; in addition, intervention format may affect its reach into the targeted recipient population.
11	n/a	Du, S., & Yuan, C. (2010). Evaluation of patient self-management outcomes in health care: a systematic review. [Article]. International Nursing Review, 57(2), 159-167.	Systematic review	CDSMP and other self-management programs targeting chronic conditions	n/a	19 studies reviewed	n/a	This systematic review showed that, among articles reporting on results of RCTs examining self-management programs, the most common outcome measures used are self-efficacy, health behaviors/attitudes, health status, health care utilization, quality of life, and psychological indicators (particularly depression).
12	USA	Ersek, M., Turner, J. A., Cain, K. C., & Kemp, C. A. (2008). Results of a randomized controlled trial to examine the efficacy of a chronic pain self-management group for older adults [ISRCTN11899548]. [Article]. Pain (03043959), 138(1), 29-40.	RCT	Pain self-management program	Community-based	Older adults, Chronic-pain specific: Treatment, n = 115; Control, n = 103	Administered questionnaire	No significant differences in outcomes were found between groups at post-intervention, 6-month follow-up, or 12-month follow-up. The self-management group showed a significantly greater increase over time, relative to the control group, in two process measures, as measured by the Chronic Pain Coping Inventory: use of relaxation and use of exercise/stretching.
13	n/a	Foster, G., Taylor SJC, Eldridge S, Ramsay J, Griffiths CJ. (2009). Self-management education programmes by lay leaders for people with chronic conditions (Review). The Cochrane Library(1), 1-77.	Systematic review	CDSMP and other self-management programs targeting chronic conditions	n/a	17 clinical trials reviewed	n/a	Lay-led self-management education programs may lead to small, short-term improvements in participants’ self-efficacy, self-rated health, cognitive symptoms management, and frequency of aerobic exercise. There is currently no evidence to suggest that such programs improve psychological health, symptoms or health-related quality of life, or that they significantly alter healthcare use. Future research on such interventions should explore longer term outcomes, their effect on clinical measure of disease and their potential role in children and adolescents.
14	USA	Gitlin, L. N., Chernett, N. L., Harris, L. F., Palmer, D., Hopkins, P., & Dennis, M. P. (2008). Harvest Health: Translation of the Chronic Disease Self-Management Program for Older African Americans in a Senior Setting. [Article]. Gerontologist, 48(5), 698-705.	Pre-post design	CDSMP	Community-based	African-American 65+, n = 414	Assessment interviews	Small but statistically significant improvements were found for health behaviors, self-efficacy, and health outcomes, but no changes were found for health utilization. Participant benefits compare favorably to original trial outcomes. The translated program is replicable and may help to address health disparities.
15	USA	Goeppinger, J., Armstrong, B., Schwartz, T., Ensley, D., & Brady, T. J. (2007). Self-management education for persons with arthritis: Managing comorbidity and eliminating health disparities. Arthritis And Rheumatism, 57(6), 1081-1088.	RCT	CDSMP and Arthritis-specific CDSMP	Community-based	Oversample of African-americans, Arthritis-specific CDSMP, n = 185; Arthritis-specific, n = 231	Mailed questionnaire	At 4 months all ASHC participants had significant improvements in self-efficacy, health behaviors, and general health. All CDSMP participants had statistically significant improvements in self-efficacy, disability, pain, and general health. African American CDSMP participants showed statistically significant improvements in general health. Statistically significant differences between the programs at 4 months were seen in pain and disability in both groups. The CDSMP produced stronger results. No significant results were found for health care utilization outcomes. Significant results at 1 year within and between programs were minimal for both groups; a decrease in number of physician visits approached significance due to changes in CDSMP participants.
16	n/a	Gordon, C. a. T. G. (2008). Review of Findings on Chronic Disease Self-Management Program (CDSMP) Outcomes: Physical, Emotional & Health-Related Quality of Life, Healthcare Utilization and Costs. 1-10.	Systematic review	CDSMP	n/a	13 studies reviewed	n/a	CDSMP results in significant, measureable improvements in patient outcomes and quality of life. CDSMP also saves enough through reductions in healthcare expenditures to pay for itself within first year.
17	USA	Haas, M., Groupp, E., Muench, J., Kraemer, D., Brummel-Smith, K., Sharma, R., et al. (2005). Chronic disease self-management program for low back pain in the elderly. Journal Of Manipulative And Physiological Therapeutics, 28(4), 228-237.	RCT	CDSMP	Community-based	Age 60+, Chronic low back pain-specific: Treatment, n = 60; Control, n = 49	Mailed questionnaire	There was no advantage for the CDSMP over a wait-list control for improving pain, general health, self-efficacy and self-care attitudes in older Americans with chronic low back pain. A benefit was suggested for emotional well-being fatigue, functional disability, and days with disability.
18	n/a	Heisler, M. (2010). Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. [Article]. Family Practice, 27(suppl), i23-i32.	Background paper on implementation and evaluation of self-management programs	Diabetes self-management programs	n/a	n/a	n/a	To be successful, peer support interventions should have clear and realistic program goals, adequate training and support for peers and sufficient overall organizational support for the program. Peer support models provide a potentially low-cost, flexible means to supplement formal health care support. Peer support models also potentially benefit both those 'receiving' the support and those 'providing' it.
19	USA	Jerant, A., Moore-Hill, M., & Franks, P. (2009). Home-based, peer-led chronic illness self-management training: findings from a 1-year randomized controlled trial. Annals Of Family Medicine, 7(4), 319-327.	RCT	Home delivered - CDSMP	Home-based	In-home, n = 138; Telephone, n = 139; Control, n = 138	Telephone and in-person questionnaire	Treatment group participants had significantly higher self-efficacy in the short term, but this was not sustained at one year. No effects were found on utilization. This study challenges the cost-effectiveness of home-based variations of the CDSMP.
20	USA	Johnson, P., & Raterink, G. (2009). Implementation of a diabetes clinic-in-a-clinic project in a family practice setting: using the plan, do, study, act model. [Article]. Journal of Clinical Nursing, 18(14), 2096-2103.	Implementation report	Diabetes self-management program	Clinic-based	n/a	n/a	This report describes the process of implementing a "clinic-within-clinic" model of chronic disease management for diabetics, using the "plan-do-study-act" process model.
21	Australia	Kendall, E., Catalano, T., Kuipers, P., Posner, N., Buys, N., & Charker, J. (2007). Recovery following stroke: The role of self-management education. [Article]. Social Science & Medicine, 64(3), 735-746.	RCT	CDSMP	Community-based	Stroke-survivorship, Treatment, n = 58; Control n = 42	Telephone questionnaire	No signficiant improvements in self-efficacy, mood, or social participation were found. However, among the control group, declines in functioning during the first year following stroke were found in the areas of family roles, activities of daily living, self-care and work productivity; these declines were not found for the treatment group. This suggests the CDSMP may have a protective function.
22	UK	Kennedy, A., Reeves, D., Bower, P., Lee, V., Middleton, E., Richardson, G., et al. (2007). 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), 254-261.	RCT	Expert Patients Programme	Community-based	Treatment, n = 313; Control, n = 316	Mailed questionnaire	This study found higher scores for overall self-efficacy and energy among the treatment group, but no differences were reported in healthcare utilization. On secondary outcomes, fewer social role limitations, better pyschological wellbeing, lower health stress, more exercise and relaxation, etc. were reported. Intervention groups were associated with better QALY profile as well as a small reduction in cost ($53).
23	USA	Lorig, K., Hurwicz, M.-L., Sobel, D., Hobbs, M., & Ritter, P. L. (2005). A national dissemination of an evidence-based self-management program: a process evaluation study. [Article]. Patient Education & Counseling, 59(1), 69-79.	Process evaluation	CDSMP	Community-based	CDSMP program coordinators and leaders, n = 516	Telephone interview	This study focused on attributes of CDSMP programs and administration that influenced success. Length of the CDSMP program was reported as a hindrance by the sites that were unsuccessful. Patient recruitment was largely sited as a problem by both successful and unsuccessful programs.
24	USA	Lorig, K., Ritter, P., Stewart, A. L., Sobel, D. S., Brown, B. W., Jr., Bandura, A., et al. (2001). Chronic disease self-management program: 2-year health status and health care utilization outcomes. Medical Care, 39(11), 1217-1223.	Pre-post design	CDSMP	Community-based	1-year follow-up, n = 683; 2-year follow-up, n = 599	Mailed questionnaire	This study suggests that the CDSMP is associated with significant continued improvements in participant health status, and reductions in health care utilization over a 2-year follow-up period. Estimated potential actual health care savings were calculated between $390 and $520 ($590 savings per participant, minus CDSMP program cost between $70 and $200 per participant).
25	UK	Lorig, K., Ritter, P. L., Dost, A., Plant, K., Laurent, D. D., & McNeil, I. (2008). The Expert Patients Programme online, a 1- year study of an Internet-based self-management programme for people with long-term conditions. Chronic Illness, 4(4), 247-256.	Pre-post design	Expert Patients Programme	Internet-based	6-month follow up, n = 459; 12-month follow up, n = 443	Online questionnaire	At six-months, significant change was found for five of seven health indicators, and all four health behaviors measured. No significant change in disability or global health was found. At one-year, significant change in six of seven health indicators was found with disability showing no change. All four health behaviors were significantly improved, and healthcare utilization continued to show significant improvment. Significant improvement in self-efficacy was found, and this change predicted outcomes for each of the six health indicators.
26	USA	Lorig, K., Ritter, P. L., & González, V. M. (2003). Hispanic chronic disease self-management: a randomized community-based outcome trial. Nursing Research, 52(6), 361-369.	RCT	CDSMP	Community-based	Spanish-speaking, Treatment n = 224; Control n = 271	Mailed and telephone questionnaire	At 4 months, greater improvement in health status, health behaviors, self-efficacy, health care utilization was found among treatment group participants. At 1 year, these improvement persisted.
27	USA & Mexico	Lorig, K., Ritter, P. L., & Jacquez, A. (2005). Outcomes of border health Spanish/English chronic disease self-management programs. The Diabetes Educator, 31(3), 401-409.	Pre-post design	CDSMP	Community-based	Spanish-speaking Mexicans and Americans, n = 445	Mailed and telephone questionnaire	This study found significant improvements in health status, health behaviors, and self-efficacy among CDSMP participants at 4 months and 1 year post-intervention. Self-efficacy at baseline and 4 months was found to be significantly associated with improvements in outcomes at 1 year post-intervention.
28	USA	Lorig, K., Ritter, P. L., Laurent, D. D., & Plant, K. (2006). Internet-based chronic disease self-management: a randomized trial. Medical Care, 44(11), 964-971.	RCT	CDSMP	Internet-based	Internet users, Treatment n = 457; Control n = 501	Online questionnaire	Intervention-group participants in this study had significantly improved health status outcomes compared to usual treatment participants at 1 year post-intervention. Change in self-efficacy at 6 months was associated with more improved health status outcomes at 1 year.
29	USA	Lorig, K., Ritter, P. L., & Plant, K. (2005). A disease-specific self-help program compared with a generalized chronic disease self-help program for arthritis patients. Arthritis And Rheumatism, 53(6), 950-957.	RCT	CDSMP and Arthritis-specific CDSMP (ASMP)	Community-based	Arthritis-specific, ASMP, n = 239; CDSMP, n = 116	Mailed questionnaire	At four months post-intervention, ASMP participants demonstrated greater improvement in health distress, activity limitation, and fatigue than CDSMP participants. At one year, participants had significantly higher improvement in global health and fatigue than CDSMP
30	USA	Lorig, K., Sobel, D. S., Stewart, A. L., Brown, B. W., Jr., Bandura, A., Ritter, P., et al. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Medical Care, 37(1), 5-14.	RCT	CDSMP	Community-based	Treatment, n = 561; Control, n = 391	Mailed questionnaire	In this study, treatment group participants showed significant improvement in duration of exercise, increased practice of cognitive symptom management, improved communication with physician, self-rated health, disability, social/role activities limitations, energy/fatigue, and health distress; in addition, fewer hospitalizations and shorter length of stay was also observed. Health care costs for control group members was calculated to be $820 greater than health care costs for treatment group members.
31	USA	Lorig, K. R., Sobel, D. S., Ritter, P. L., Laurent, D., & Hobbs, M. (2001). Effect of a self-management program on patients with chronic disease. Effective Clinical Practice: ECP, 4(6), 256-262.	Pre-post design	CDSMP	Community-based	n = 489	Self-administered questionnaire	At 1 year, participants in the program experienced statistically significant improvements in health behaviors, self-efficacy, and health status and had fewer visits to the emergency department. Program costs were estimated to be about $200 per participant.
32	Australia	Nolte, S., Elsworth, G. R., Sinclair, A. J., & Osborne, R. H. (2007). The extent and breadth of benefits from participating in chronic disease self-management courses: A national patient-reported outcomes survey. [Article]. Patient Education & Counseling, 65(3), 351-360.	Pre-post design	Self-management programs targeting chronic conditions	Community-based	n = 842	Self-administered questionnaire	Attendees of self-management programs in Australia experienced substantial improvements in skill and technique acquisition and self-monitoring and insight, as well as improvement in other health domains. It appeared that younger female particpants may stand to gain the most benefit from such programs. Educational differences do not seem to impact the potential of experiencing improvements or decline.
33	ustralia	Osborne, R. H., Elsworth, G. R., & Whitfield, K. (2007). The Health Education Impact Questionnaire (heiQ): An outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions. [Article]. Patient Education & Counseling, 66(2), 192-201.	Measure development	Evaluation tool for self-management programs	n/a	Calibration sample = 591; Validation sample = 598	Self-administered questionnaire	This paper reports the development and testing of the Health Education Impact Questionnaire (heiQ). Eight independent scales with very good or good psychometric properties were developed: Positive and Active Engagement in Life, Health Directed Behavior, Skill and Technique Acquisition, Constructive Attitudes and Approaches, Self Monitoring and Insight, Health Services Navigation, Social Integration and Support, Emotional Wellbeing (reversed scale)
34	USA	Powers, B. J., Olsen, M. K., Oddone, E. Z., & Bosworth, H. B. (2009). The Effect of a Hypertension Self-Management Intervention on Diabetes and Cholesterol Control. [Article]. American Journal of Medicine, 122(7), 639-646.	RCT	Hypertension self-management program	Telephone-based	Diabetes study: Treatment, n = 102; Control, n = 117. Cholesterol study: Treatment, n = 269; Control, n = 259.	Electronic medical record review	This study found significant effects of a hypertension self-management program on diabetes-related indicators, but not on cholesterol-related indicators. Findings suggest that self-management programs do have the potential to influence unintended outcomes, such as glycemic control.
35	UK	Richardson, G., Kennedy, A., Reeves, D., Bower, P., Lee, V., Middleton, E., et al. (2008). Cost effectiveness of the Expert Patients Programme (EPP) for patients with chronic conditions. [Article]. Journal of Epidemiology & Community Health, 62(4), 361-367.	RCT	Expert Patients Programme	Community-based	Treatment, n = 247; Control, n = 273	Self-administered questionnaire	The findings of this study showed an association between treatment group and gains in quality adjusted life years, and a reduction in care costs of approximately ₤27 per patient.
36	UK	Rogers, A., Kennedy, A., Bower, P., Gardner, C., Gately, C., Lee, V., et al. (2008). The United Kingdom Expert Patients Programme: results and implications from a national evaluation. The Medical Journal Of Australia, 189(10 Suppl), S21-S24.	Evaluation report	Expert Patients Programme	Community-based	See Kennedy et al., 2007	See Kennedy et al., 2007	See Kennedy et al., 2007 for RCT results. This report suggests that the Expert Patients Programme is likely to be cost-effective, and may yeild benefits not measured by frequently-used evaluation tools, such as increased social networks.
37	UK	Rogers, A., Kennedy, A., Nelson, E., & Robinson, A. (2005). Uncovering the Limits of Patient-Centeredness: Implementing a Self-Management Trial for Chronic Illness. [Article]. Qualitative Health Research, 15(2), 224-239.	Qualitative interview with subsample of RCT participants	Expert Patients Programme	Community-based	Inflammatory bowel disease patients, n = 28; Intervention consultants, n = 11	Telephone and in-home qualitative interviews	Findings from this study suggest that a number of factors may inhibit effective patient-centered consultations in self-management programs, including failure of physicians to incorporate expressed need relevant to people's self-management activities fully, interpretation of self management as compliance with medical instructions, and the organization of outpatients’ clinics.
38	USA	Rose, M. A., Arenson, C., Harrod, P., Salkey, R., Santana, A., & Diamond, J. (2008). Evaluation of the Chronic Disease Self- Management Program With Low-Income, Urban, African American Older Adults. [Article]. Journal of Community Health Nursing, 25(4), 193-202.	Pre-post design	CDSMP	Community-based	Low-income, urban, older African-Americans, n = 68	Self-administered questionnaire	This study found significant improvements in some health status and health behaviors, but did not find significant improvement in self-efficacy or health care utilization.
39	USA	Rosenman, M. B., Holmes, A. M., Ackermann, R. T., Murray, M. D., Doebbeling, C. C., Katz, B., et al. (2006). The Indiana Chronic Disease Management Program. [Article]. Milbank Quarterly, 84(1), 135-163.	Implementation report	Indiana CDSMP	Telephone-based	Adults from Indiana with diabetes or congestive heart failure	Administrative claims, electronic medical records system, telephone center logs, self-reported data from practices	This article describes a state-developed chronic disease management program, with telephonic intervention designed to stimulate self-care, encourage provision of core medical care, and offer educational resources. It also discusses considerations for the evaluation of the program.
40	USA	Sequist, T. D., von Glahn, T., Li, A., Rogers, W. H., & Safran, D. G. (2009). Statewide evaluation of measuring physician delivery of self-management support in chronic disease care. Journal Of General Internal Medicine, 24(8), 939-945.	Measurement validation	Measure of self-management support	n/a	Respondents to annual statewide patient survey with chronic disease, n = 80,597	Mailed questionnaire	This study found that the new measure for self-management support was feasible and valid, with a minimum sample size required to reliably estimate support of 199. Scores for this measure were highest for patients with cancer, and lowest for patients with hypertension
41	The Netherlands	Smeulders, E. S. T. F., van Haastregt, J. C. M., Ambergen, T., Janssen-Boyne, J. J. J., van Eijk, J. T. M., & Kempen, G. I. J. M. (2009). The impact of a self-management group programme on health behaviour and healthcare utilization among congestive heart failure patients. European Journal Of Heart Failure: Journal Of The Working Group On Heart Failure Of The European Society Of Cardiology, 11(6), 609-616.	RCT	CDSMP	Community-based	Congestive heart failure-specific, Treatment n = 131; Control n = 186	Telephone interview	Significant improvements in walking were found at immediate post-intervention follow-up but not at 6 or 12 months post-intervention. Significant change in other physical exercises was observed at direct follow-up and 6 months, but not one year. No significant change in drinking, smoking, body mass index, swimming, biking, health care utilization was found.
42	USA	Sobel, D. S., Kate R Lorig, Mary Hobbs. (2002). Chronic Disease Self-Management Program: From Development to Dissemination. The Permanente Journal, 6(2), 15-22.	Evaluation report	CDSMP	Community-based	n/a	Quantitative and qualitative methods	This report provides evidence that CDSMP, when integrated into patient care, can improve health outcomes for patients both medically and emotionally. Tools were replicated and successfully disseminated in other areas, and researchers noted that degree of leadership buy-in and support, and adequacy of infrastructure and staff can have a great affect on the program's success. Patients must also be successfully recruited by the organization and have an individual commitment to the program. In addition, recruitment into a generic CDSMP as compared to a disease-specific program led to competition with other programs and confusion among participants and physicians of the program's role. Longitudinal study results show that hospitalization and hospital stays decreased, saving an average of $990 per particpant in the first year (comparing cost of program to hospital costs).
43	Australia	Swerissen, H., Belfrage, J., Weeks, A., Jordan, L., Walker, C., Furler, J., et al. (2006). A randomised control trial of a self-management program for people with a chronic illness from Vietnamese, Chinese, Italian and Greek backgrounds. Patient Education And Counseling, 64(1-3), 360-368.	RCT	CDSMP	Community-based	Greek, Italian, Vietnamese, or Chinese-speaking, Treatment n = 320; Control n = 154	In-person, mailed, and telephone questionnaire	This study demonstrated that the CDSMP can effectively be translated and implemented in a variety of languages in Australia. The intervention group had significantly higher levels of energy, exercised more frequently, used more cognitive symptom management techniques, and reported higher levels of selfefficacy and self-rated health compared to the control group. No significant differences were found in service use, and health outcomes and service use varied among language group.
44	USA	Young, A. S., Chaney, E., Shoai, R., Bonner, L., Cohen, A. N., Doebbeling, B., et al. (2007). Information Technology to Support Improved Care For Chronic Illness. [Article]. JGIM: Journal of General Internal Medicine, 22, 425-430.	Systematic review and expert panel	Chronic illness care	n/a	n/a	n/a	Researchers funded by the Department of Veteran Affairs performed a literature review, convened an expert panel, and created use cases for four chronic illnesses: depression, schizophrenia, diabetes, and comorbid disorders. Literature—much of which was nonexperimental—was used along with expert interviews to develop use cases for HIT management. The "recovery" model was seen as applicable to other chronic disorders. Automatic scoring algorithms were recommended for outcome-based quality improvement, as well as the use of EMRs that allow patients and physicians to track all phases of treatment. This gave focus to the use of HIT (EMRs or PHRs) as a specific tool in managing chronic illness, rather than a method by which to track it.

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