Disease management support programs help patients maintain medication adherence.
In a recent study, researchers analyzed factors that influence the acceptance and completion rates of Stanford Chronic Disease Self-Management Program (CDSMP), as well as the experience of participants and peer leaders. The results showed that the program is beneficial for patients with chronic illnesses and could potentially boost medication adherence, saving on long-term healthcare costs.
This program typically includes weekly meetings for 6 weeks facilitated by 2 peer leaders who also have chronic illnesses.
During meetings, techniques to deal with frustration, pain, fatigue, and isolation are discussed. Strength-maintaining exercises, medication usage, communication with others, nutrition, decision-making, and how to evaluate new treatments were also considered.
Included in the current study were 43 patients between 18 and 80 years of age, and all participants had at least 1 chronic disease.
To be included, patients needed to be designated by their physician as frequent users of healthcare services who would likely benefit from case management intervention by a primary care nurse.
Characteristics that include age, sex, marital status, and patient income were gathered through questionnaires.
Interviews and focus groups were conducted, which allowed patients to describe their needs, previous experience with healthcare services, why they chose to participate, and their experience with the program.
Researchers found that participants who dropped out of the program were in too poor health to attend meetings. Other factors such as location, schedule, content, group composition, and facilitation were also reasons participants left, according to the study.
Heterogeneity of the group also effected the dropout rate, according to the program coordinator and the peer leaders. Some participants felt their condition was not as severe as other patient and did not feel comfortable enough to talk about their condition.
One peer leader said heterogeneity made it difficult to make connections between the participants.
Only 28 participants successfully completed the program, while 12 participants attended all of the sessions.
A majority of participants who attended at least half or more of the sessions said the program improved their knowledge, motivation, and self-confidence.
Participants said they gained more knowledge about certain diseases, as the group helped them realize they are still able to perform tasks despite their illnesses.
Of those who initially accepted the invitation, 28% did not start the program. Researchers found a comparable acceptance rate among other similar studies.
Of those who started, 65% of participants completed the program.
The CDSMP could be considered a valuable self-management support option for vulnerable patients due to the overall positive impact seen by patients.
To improve completion rates, researchers suggest more homogeneity among participants’ age, severity of disease, cognitive function, and mental age. The study concluded participation could also be boosted by making meetings more accessible in regards to time and location in order to further improve the program.