Chronic Disease Self-Management (CDSMP)

The teaching process makes this program effective. Classes are highly participatory. Mutual support and success builds participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.


Format

  • Small group workshop
  • 2 1/2 hours per session
  • 1 session per week for 6 weeks

Settings

  • Community settings such as senior centers, churches, libraries and hospitals.
  • Special attention should be given to making the location accessible to all.
  • A room large enough for all participants to gather comfortably, plus space for 2 leaders and their materials.

Participants

  • People with different chronic health problems attend together.
  • 12 - 16 participants per workshop

Materials

Language Options

Chinese 2012 
Creole (Haitian) 2012 
Danish 2012 
Finnish 2012 
Hmong 2012 
Arabic 2012

Japanese 2012 
Samoan 2012 
Tongan 2012 
Vietnamese 2012 
Hindi 2012

Please contact us for more information: smrc@selfmanagementresource.com

Leaders

  • Two trained leaders, one or both of whom are non-health professionals with chronic diseases themselves.
  • Must be trained by certified Master Trainers, or must be Master Trainers themselves.
  • For information about attending a Master Trainer training, please visit our Training section.

Subjects Taught

(Note: Participants make weekly action plans, share experiences, and help each other solve problems they encounter in creating and carrying out their self-management program. Physicians and other health professionals both at Stanford and in the community have reviewed all materials in the workshop.)

  • Techniques to deal with problems such as frustration, fatigue, pain and isolation.
  • Appropriate exercise for maintaining and improving strength, flexibility, and endurance
  • Appropriate use of medications
  • Communicating effectively with family, friends, and health professionals
  • Nutrition
  • Decision making
  • How to evaluate new treatments

Frequently Asked Questions Below!

Does the Program replace existing programs and treatments?

The Self-Management Program will not conflict with existing programs or treatment. It is designed to enhance regular treatment and disease-specific education such as Better Breathers, 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.

How was the Program developed?

The Division of Family and Community Medicine in the School of Medicine at Stanford University received a five year research grant from the federal Agency for Health Care Research and Policy and the State of California Tobacco-Related Diseases office. The purpose of the research was to develop and evaluate, through a randomized controlled trial, a community-based self-management program that assists people with chronic illness. The study was completed in 1996.

The research project had several investigators: Halsted Holman, M.D., Stanford Professor of Medicine; Kate Lorig, Dr.P.H., Stanford Professor of Medicine; David Sobel, M.D., Regional Director of Patient Education for the Northern California Kaiser Permanente Medical Care Program; Albert Bandura, Ph.D., Stanford Professor of Psychology; and Byron Brown, Jr., Ph.D., Stanford Professor of Health Research and Policy. The Program was written by Dr. Lorig, Virginia González, M.P.H., and Diana Laurent, M.P.H., all of the Stanford Patient Education Research Center. Ms González and Ms Laurent also served as integral members of the research team.

The process of the program was based on the experience of the investigators and others with self-efficacy, the confidence one has that he or she can master a new skill or affect one’s own health. The content of the workshop was the result of focus groups with people with chronic disease, in which the participants discussed which content areas were the most important for them.

How was the Program evaluated?

Over 1,000 people with heart disease, lung disease, stroke or arthritis participated in an randomized, controlled test of the Program, and were followed for up to three years. We looked for changes in many areas: health status (disability, social/role limitations, pain and physical discomfort, energy/fatigue, shortness of breath, psychological well-being/distress, depression, health distress, self-rated general health), health care utilization (visits to physicians, visits to emergency department, hospital stays, and nights in hospital), self-efficacy (confidence to perform self-management behaviors, confidence to manage disease in general, confidence to achieve outcomes), and self-management behaviors (exercise, cognitive symptom management, mental stress management/relaxation, use of community resources, and communication with physician).**

What were the results?

Subjects who took the Program, when compared to those who did not, demonstrated significant improvements in exercise, cognitive symptom management, communication with physicians, self-reported general health, health distress, fatigue, disability, and social/role activities limitations. They also spent fewer days in the hospital, and there was also a trend toward fewer outpatients visits and hospitalizations. These data yield a cost to savings ratio of approximately 1:4. Many of these results persist for as long as three years.*** Studies by others have reported similar results (see our bibliography).

How can my facility offer the Program?

Trainings for representatives of health care organizations are 4½ days. There are 4-5 trainings scheduled at each year. Visit Training to learn more.

How can I evaluate the Program?

There are a number of Evaluation Tools available for your use HERE.

***Outcome data reported in (more citations in bibliography):

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.

Lorig KR, Ritter P, 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.

In HMO setting: 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.

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