title: Can a Box of Mailed Materials Achieve the Triple Aims of Health Care? The Mailed Chronic Disease Self-Management Tool Kit Study.
abstract: Not all patients with chronic conditions are able or willing to participate in small-group or Internet self-management programs. Based on the Arthritis Mailed Took Kit Program and the Chronic Disease Self-Management Program, a mailed Chronic Disease Self-Management Tool Kit, delivered in a onetime mailing, was developed as an alternative mode of delivery. Kits were mailed to a national sample of 255 participants with varying chronic conditions and evaluated in a longitudinal (6-month) trial. Outcomes reflected the triple aims of health care. At 6 months, participants demonstrated better health care indicators, better health indicators, and less health care utilization. There were significant improvements in two health care indicators and six health indicators and reductions in physician visits. Follow-up response rate was high (85%). There were no significant baseline differences between responders and nonresponders. Subgroup analyses were performed for a number of subgroups, including those with arthritis (58%) and/or depression (43%), and for African Americans (14%). Subgroups demonstrated improvements equal to or better than the overall group. The Mailed Chronic Disease Self-Management Tool Kit represents a third mode, along with small groups and Internet, of delivering self-management patient education, and appears to contribute to meeting the triple aims of health care for those who actively chose this mode of delivery.
authors.affiliation: Stanford University School of Medicine, Palo Alto, CA, USA Stanford Patient Education Research Center, Palo Alto, CA, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Lorig
authors.affiliation: Stanford Patient Education Research Center, Palo Alto, CA, USA philr@stanford.edu.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Ritter
authors.affiliation: Stanford Lucile Packard Children's Hospital, Palo Alto, CA, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Moreland
authors.affiliation: Stanford Patient Education Research Center, Palo Alto, CA, USA.
authors.forename: Diana D
authors.initials: DD
authors.lastname: Laurent
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D002908:Chronic Disease / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010817:Physician-Patient Relations; D011177:Postal Service; D015397:Program Evaluation; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: arthritis; chronic disease; health education; patient education