A self-management support program for older Australians with multiple chronic conditions: a randomised controlled trial.

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, 1.13-5.50; 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.