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A self-management support program for older Australians with multiple chronic conditions: a randomised controlled trial [with consumer summary] |
Reed RL, Roeger L, Howard S, Oliver-Baxter JM, Battersby MW, Bond M, Osborne RH |
The Medical Journal of Australia 2018 Feb;208(2):69-74 |
clinical trial |
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: To determine whether a clinician-led chronic disease self-management support (CDSMS) program improves the overall self-rated health level of older Australians with multiple chronic health conditions. DESIGN: Randomised controlled trial: participants were allocated to a clinician-led CDSMS group (including client-centred goal setting and the development of individualised care plans) or to a control group in which they received positive attention only. SETTING AND PARTICIPANTS: Patients aged 60 years or more with at least two chronic conditions, recruited between September 2009 and June 2010 from five general practices in Adelaide. MAIN OUTCOME MEASURES: The primary outcome was self-rated health. Secondary outcome measures related to health status (fatigue, pain, health distress, energy, depression, illness intrusiveness), health behaviour (exercise, medication adherence), and health service utilisation. RESULTS: 254 participants were randomised to the CDSMS and control groups, of whom 231 (117 control and 114 CDSMS participants) completed the 6-month programs and provided complete outcomes data (91%). An intention-to-treat analysis found that CDSMS participants were more likely than control participants to report improved self-rated health at 6 months (odds ratio 2.50; 95% confidence interval 1.13 to 5.50; p = 0.023). Between-group differences for secondary outcomes were not statistically significant. CONCLUSION: CDSMS may benefit some older people with multiple chronic conditions to a greater extent than positive attention and health education. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12609000726257.
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