Internet-based chronic disease self-management: a randomized trial.
BACKGROUND
The small-group Chronic Disease Self-Management Program (CDSMP) has proven effective in changing health-related behaviors and improving health statuses. An Internet-based CDSMP was developed to reach additional chronic-disease patients.


OBJECTIVE
We sought to determine the efficacy of the Internet-based CDSMP.


METHODS
We compared randomized intervention participants with usual-care controls at 1 year. We compared intervention participants with the small-group CDSMP at 1 year.


METHODS
Nine-hundred fifty-eight patients with chronic diseases (heart, lung, or type 2 diabetes) and Internet and e-mail access were randomized to intervention (457) or usual care control (501).


METHODS
Measures included 7 health status variables (pain, shortness of breath, fatigue, illness intrusiveness, health distress, disability, and self-reported global health), 4 health behaviors (aerobic exercise, stretching and strengthening exercise, practice of stress management, and communication with physicians), 3 utilization variables (physician visits, emergency room visits, and nights in hospital), and self-efficacy.


RESULTS
At 1 year, the intervention group had significant improvements in health statuses compared with usual care control patients. The intervention group had similar results to the small-group CDSMP participants. Change in self-efficacy at 6 months was found to be associated with better health status outcomes at 1 year.


CONCLUSIONS
The Internet-based CDSMP proved effective in improving health statutes by 1 year and is a viable alternative to the small-group Chronic Disease Self Management Program.
Lorig
Kate R
KR
Stanford University School of Medicine, Stanford, California 94306, USA.
Ritter
Philip L
PL
Laurent
Diana D
DD
Plant
Kathryn
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006305:Health Status Indicators; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013997:Time Factors