The efficacy of tailored interventions for self-management outcomes of type 2 diabetes, hypertension or heart disease: a systematic review.
OBJECTIVE
To evaluate the evidence on the effectiveness of tailored interventions on self-management behaviours in individuals with heart disease, hypertension or type 2 diabetes.


BACKGROUND
Tailored interventions are designed for individuals based on their unique characteristics, related to the outcome of interest, and derived from an individual assessment. Recognizing the differences between individuals and delivering interventions tailored to the individual could increase the likelihood of sustained self-management of long-term conditions. Review methods.  A review of randomized controlled trials published between 2001 and 2010 was undertaken using the following databases: Pubmed, WOS, CINAHL, ERIC, ASP, PsychInfo and SSA. The search terms included tailored intervention(s), and self-management of chronic diseases included in the aim. Reference lists from relevant articles were also examined for additional references.


RESULTS
Ten studies were included in the review. Tailored interventions had no impact on self-management activities such as medication adherence, self-monitoring, exercise, smoking, or diet control. However, tailored interventions were modestly successful in improving specific self-management behaviours of dietary fat intake, levels of physical activity or screening. Studies included in the review generally suffered from compromised methodological issues of inadequately powered sample size, non-blinding of data collection or intervention delivery and inadequate reporting of the randomization process.


CONCLUSIONS
When cost and resource utilization is taken into consideration, tailored interventions may not be more effective than standard interventions in improving self-management behaviours in individuals with long-term conditions. Future research should explore the effect of robust and resource-optimized tailored interventions on self-management outcomes for long-term conditions with high-quality trials.
Center for Transitions and Health University of Pennsylvania, Philadelphia, PA, USA. kavitar6@gmail.com
Kavita
K
Radhakrishnan
D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000451:nursing / Q000628:therapy*; D015438:Health Behavior; D006331:Heart Diseases / Q000451:nursing / Q000628:therapy*; D006801:Humans; D006973:Hypertension / Q000451:nursing / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010347:Patient Care Planning; D010353:Patient Education as Topic; D016032:Randomized Controlled Trials as Topic; D012648:Self Care