Jerant et al. (2009)

Assess long-term effects of the CDSMP beyond 6 months

Not stated

Home based variant of CDSMP called Homing in on Health (HIOH)

U.S.

RCT, measured at baseline, 6 weeks, 6 months, and 1 year.

・ N = 415

・ Convenience sample

・ Randomized to usual care, HIOH, or telephone intervention.

・ 78% - 75% female per group

・ Mean age: 60

・ Caucasian 75%

・ Education: majority some college or beyond

・ Heterogeneous Disease Sample

・ Demographics

・ Self-Efficacy (Cronbach’s alpha = 0.96)

・ Health Status: SF-36 (previous validation)

・ Medical Outcomes Survey on General Health and EuroQol (EQ) health status and Visual Analog Scale (EQ VAS) (validity not addressed)

・ Functional Ability: Health-Assessment Questionnaire (composite alpha 0.92)

・ Hospital days prior to study

・ The home group had significant increase in self-efficacy at 6 weeks and 6 years, but no difference at 1 year.

・ Health Status: the EQ VAS was increased in the home group at all three measured intervals, all other assessment of health status were not significant.

・ There were no significant effects on hospitalization at 1 year

・ Statistical significance not addressed

Interpretation:

Consistent with previous studies that suggest that the CDSMP has short-term moderate effects. Questions whether implementation of CDSMP would be cost effective.

Limitations:

Majority were Caucasian, female, married, and well-educated which questions the generalizability. Participation was voluntary which may have affected the type of population and the dropout rate in the intervention group was high. Self-report instruments

Generalizability: limited due to sample characteristics nor representative of population, volunteers could limit generalizability

Rose et al. (2009)

Evaluate the effectiveness of the CDSMP when used with Urban African American older adults

Concept of Self-efficacy

Senior center, senior housing, and churches

U.S.

・ 1 group pretest and posttest design

・ 6 week CDSMP, adapted for African American population,

・ Lay leader from community and health professional

・ Follow up at 10 weeks and 6 months

・ N = 153

・ 86% African American

・ Mean Age: 72

・ 82% female

・ Education 11.5 years

・ Heterogeneous Disease Sample

・

・ Demographics

・ Health Status

・ Health Service Utilization

・ Health Behavior

・ Perceived self-efficacy

・ Chronic Disease Impact

・ (all previously published validity and reliability)

・ At 10 weeks:

・ Health behaviors showed a significant increase in stretching and strengthening (p = 0.04). 6 months (p = 0.03)

・ Significant increase in cognitive symptom management @10 weeks (P = 0.01); 6 months not significant

・ Improvement in health status variables, but not significant

・ No significant improvement in self-efficacy, healthcare utilization, or illness intrusiveness

・ Interpretation:

Participants felt needed more sessions.

Results suggest potential benefit in this population

・ Limitations:

No control group or randomization, High attrition rate in follow up data,

・ Generalizability:

Cannot generalize the findings to African American Older Adults due to small sample size, volunteers could limit generalizability

Ersek et al. (2008)

Determine the efficacy of a pain self-management support group versus a self-education control group

None stated

(CDSMP as resource)

Retirement communities

U.S.

・ Clustered RCT -baseline measured prior to randomization, assessed after intervention and at one year.

・ Pain Self-Management Group: 7 weekly sessions

・

・ Leaders were nurses and psychologists

・ Randomized by facility to control or intervention group.

・ N = 255

・ Mean Age 82 years

・ 87% female

・ 93% Caucasian

・ 70% with post-secondary education

・ Diagnosed with arthritis

・ Demographics

・ Physical Disability: Roland Morris Disability Questionnaire (Validity/reliability and responsiveness to change addressed)

・ Pain intensity and interference: Brief Pain Inventory (reliability and validity stated)

・ Self-efficacy: Arthritis Efficacy Scale (internal consistency and test ?retest reliability)

・ Catastrophizing: Coping strategy questionnaire (validity and reliability in older adults stated)

・ -Coping: Chronic Pain Coping Inventory (acceptable internal consistency and test-retest reliability)

・ In self-management group coping increased significantly over control group at post intervention and decrease in 1 year

・ No significant change in medication use in either group at post intervention or 1 year.

・ Slight decrease in pain and disability at 6 months with a 12% increase in pain in intervention group versus a 19% increase in the control group at 1 year.

・ Exercise (0.03) and relaxation (0.003) were only outcomes with statistical significance

Interpretation:

Self-management may not be effective for all types of chronic disease. The overall study showed little effect between the self-management group and the study group.

Recommendations for further studies evaluate effectiveness

Limitations: not addressed, Self-report

Generalizability:

Cannot be generalized, volunteers could limit generalizability