National Study of the Chronic Disease Self-Management Program meets Triple Aims and shows Potential for Expansion

Emerging health care reform initiatives are of growing importance due to concerns about providing care to increasing numbers of adults with multiple chronic conditions. A national study of the Chronic Disease Self-Management Program (CDSMP) recently completed a 12-month assessment of over 800 participants across 17 states documenting positive impacts on the triple aim health care goals of achieving better health, better health care and better value in terms of reduced health care costs at a national level.

“Successes of a National Study of the Chronic Disease Self-Management Program: Meeting the Triple Aim of Health Care Reform,” published in Medical Care was led by Regents and Distinguished Professor Marcia G. Ory, Ph.D., M.P.H., of the Texas A&M Health Science Center School of Rural Public Health. Collaborators were Kate Lorig, Dr.P.H., from the Stanford University School of Medicine and Nancy Whitelaw, Ph.D., from the National Council on Aging.

“In the United States adults with chronic conditions consume 75% of health care expenditures,” said Dr. Ory. “Self-management is an essential strategy for avoiding the onset of chronic conditions and helping those with diseases to manage their conditions more effectively. Under controlled conditions, self-management programs have been shown to promote healthy behaviors, improve health status, and reduce health care utilization and costs.”

This study confirms that the CDSMP can be successfully applied to larger and more diverse populations reached through a variety of aging, public health and health care organizations and still produce similar results. According to Dr. Ory this study is the first to look specifically at the ability of the CDSMP to facilitate the Triple Aim goals set out by the Affordable Care Act. Study participants showed significant improvements across all of the three goals with reports of better overall health, less pain, fatigue, and depression; improved physician-patient communication; and significant decreases in emergency room visits and hospitalizations.

“The focus of this study was to answer basic questions about the representativeness of the study participants and whether a national rollout of CDSMP could duplicate findings,” said Lorig, the original program developer. “This national study demonstrates the successful translation of the CDSMP into widespread practice.”

The CDSMP has shown that it is capable of having a lasting impact on individuals with chronic conditions and how they manage their treatment and care. Whitelaw concludes, “Continuing success and expansion of this program depends on the improved availability of and access to evidence-based self-management programs.” Especially recommended by the research team are dedicated financing streams for such programs and better cooperation across aging, public health and health care sectors to build sustainable systems for promoting self-management strategies.

Additional authors include Luohua Jiang, Ph.D., Texas A&M School of Rural Public Health; Phillip Ritter, Ph.D. and Diana D. Laurent, M.P.H., Stanford University School of Medicine; SangNam Ahn, Ph.D., University of Memphis; and Matthew Lee Smith, Ph.D. of University of Georgia-Athens.