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A self‐management support program for older Australians with multiple chronic conditions: a randomised controlled trial
Author(s) -
Reed Richard L,
Roeger Leigh,
Howard Sara,
OliverBaxter Jodie M,
Battersby Malcolm W,
Bond Malcolm,
Osborne Richard H
Publication year - 2018
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja17.00127
Subject(s) - medicine , randomized controlled trial , self management , physical therapy , depression (economics) , distress , odds ratio , confidence interval , gerontology , clinical psychology , machine learning , computer science , economics , macroeconomics , surgery , pathology
Objective: To determine whether a clinician‐led chronic disease self‐management support (CDSMS) program improves the overall self‐rated health level of older Australians with multiple chronic health conditions. Design: Randomised controlled trial: participants were allocated to a clinician‐led CDSMS group (including client‐centred goal setting and the development of individualised care plans) or to a control group in which they received positive attention only. Setting and participants: Patients aged 60 years or more with at least two chronic conditions, recruited between September 2009 and June 2010 from five general practices in Adelaide. Main outcome measures: The primary outcome was self‐rated health. Secondary outcome measures related to health status (fatigue, pain, health distress, energy, depression, illness intrusiveness), health behaviour (exercise, medication adherence), and health service utilisation. Results: 254 participants were randomised to the CDSMS and control groups, of whom 231 (117 control and 114 CDSMS participants) completed the 6‐month programs and provided complete outcomes data (91%). An intention‐to‐treat analysis found that CDSMS participants were more likely than control participants to report improved self‐rated health at 6 months (odds ratio, 2.50; 95% confidence interval, 1.13–5.50; P = 0.023). Between‐group differences for secondary outcomes were not statistically significant. Conclusion: CDSMS may benefit some older people with multiple chronic conditions to a greater extent than positive attention and health education. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12609000726257.