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Correspondence: Hannah Katch The George washington University, Department of Health Policy, washington DC, USA Tel +1 202 994 3367 email hannah.katch@gwumc.edu Research objective: To conduct a comprehensive, systematic review of disease self-management programs for patients with cardiovascular disease (CVD), looking specifically at those with self-efficacy as a key component to the effectiveness of such programs on CVD management and outcomes. Study design: We conducted a review of effective strategies promoting patient involvement and engagement in the self-management of CVD. To narrow the scope of the review, we defined strategies that were empirically tested and showed a measurable and positive impact on outcomes that reflect improved self-management (eg, medication adherence or patient’s perceived management skills) and/or improved clinical outcomes (eg, lower blood pressure or reduced hospitalization). Results: We identified five disease management programs focusing on self-efficacy that had been rigorously evaluated by multiple studies in varying patient populations. Each of these programs were shown to be effective in increasing patients’ engagement and involvement in the management of their disease, by demonstrating improvement in self-efficacy while developing patients’ self-management skills. They also were shown to improve clinical outcomes for patients, such as lower blood pressure and reduced hospitalizations. Conclusion: The studies that we reviewed demonstrate the importance of including selfefficacy as a key component in CVD self-management programs. These programs should be multidisciplinary in approach, should be tailored to the needs of the patients, and should have a theoretical foundation of behavior change. More research is needed to investigate the causal link between self-efficacy, self-management and clinical outcomes.

The role of self-efficacy in cardiovascular disease self-management: a review of effective programs