The impact of a self-management group programme on health behaviour and healthcare utilization among congestive heart failure patients.
OBJECTIVE
The 'Chronic Disease Self-Management Programme' (CDSMP) emphasizes patients' responsibility for the day-to-day management of their condition(s) and has shown favourable effects on health behaviour and healthcare utilization among various groups of patients with chronic conditions. However, the effects of the CDSMP among congestive heart failure (CHF) patients are unknown. We therefore aimed to assess the effects of the CDSMP on health behaviour and healthcare utilization in patients with CHF.


RESULTS
This randomized, controlled trial with 12 months of follow-up included 317 CHF patients with a slight to marked limitation of physical activity. Control patients (n = 131) received usual care, consisting of regular checkups at an outpatient clinic. Intervention group patients (n = 186) received usual care and participated in a 6-week self-management group programme. Favourable effects on walking for exercise and other physical activities such as aerobic, stretching, and strength exercises, sports, and gardening were reported in the intervention group immediately after completion of the programme. The effect of the programme on other physical activities extended to 6 months of follow-up. No favourable effects were found for the other outcomes.


CONCLUSIONS
The CDSMP significantly improved physical activity among CHF patients for up to 6 months after the end of the programme; however, it did not affect other health behaviour outcomes or healthcare utilization.
Department of Health Care and Nursing Science, School for Public Health and Primary Care: CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200 MD, The Netherlands. e.smeulders@zw.unimaas.nl
Esther S T F
ES
Smeulders
Jolanda C M
JC
van Haastregt
Ton
T
Ambergen
Josiane J J
JJ
Janssen-Boyne
Jacques Th M
JT
van Eijk
Gertrudis I J M
GI
Kempen
D000368:Aged; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006333:Heart Failure / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D015397:Program Evaluation / Q000379:methods*; D012189:Retrospective Studies; D012648:Self Care / Q000379:methods*; D013997:Time Factors