title: A systematic review of outcomes of chronic disease self-management interventions.
abstract: OBJECTIVE
  To carry out a systematic review of program outcomes used in the evaluation of group-based self-management interventions aimed at people with arthritis and other chronic conditions.
  
  
  METHODS
  The systematic search was performed across databases MEDLINE, EMBASE, CINAHL, and PsycINFO. Both between-group and within-group effect sizes (ES) were calculated. Results were interpreted as small (ES ~ 0.2), medium (ES ~ 0.5), or large (ES ~ 0.8) effects.
  
  
  RESULTS
  The majority of 18 included trials investigated the effectiveness of arthritis-specific interventions. Across most outcomes, small effects on course participants were shown. While effects on knowledge were large (between-group ES = 0.78), effects on clinical outcomes such as pain (ES = 0.10) were negligible to small.
  
  
  CONCLUSIONS
  This paper is consistent with other reviews in this area, suggesting that people with arthritis receive only marginal benefits from participating in chronic disease self-management interventions. When looking at the types of outcomes that trials are based on, however, alternative explanations for these results seem probable. As evaluations heavily rely on patient self-report, current approaches to program evaluation may not be sufficient to assess the intended impact of self-management education. An in-depth investigation of the types of outcomes assessed is provided in a separate paper.
authors.affiliation: Medical Clinic for Psychosomatics, Charité, University Medicine Berlin, Luisenstraße 13a, 10117, Berlin, Germany. sandra.nolte@charite.de
authors.forename: Sandra
authors.initials: S
authors.lastname: Nolte
authors.forename: Richard H
authors.initials: RH
authors.lastname: Osborne
mesh_terms: D001168:Arthritis / Q000628:therapy*; D002908:Chronic Disease / Q000628:therapy*; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D012648:Self Care; D012657:Self-Help Groups