What is the State of Patient Self-Management Support Programs? An Evaluation
An Evaluation
To improve its services continuously, the Department of Health and Human Services (HHS) evaluates its programs to examine the performance of those programs in achieving their objectives. An important part of the HHS evaluation function is communicating the findings and recommendations of the evaluation studies.
This report evaluates a program of the Agency for Healthcare Research and Quality (AHRQ). It was prepared by RAND.
Select to download Print Version Self Management Support Programs final report - RAND 7-13-2007.doc [ - 713 KB]
By Marjorie L. Pearson, Soeren Mattke, Rebecca Shaw, M. Susan Ridgely, and Shelley H. Wiseman.
Contents
Acknowledgments
Summary
Introduction and Purpose
Background
Chronically Ill Patients Could Use Some Help
Self-Management Support is More Than Patient Education
Self-Management Support Has Strong Advocates
Self-Management Support Can Improve Quality of Care and Control Costs
Much Remains to be Learned about the Relative Effectiveness of Program Components
RAND Methodology
Literature Review
Interviews with Self-Management Support Experts
Design Options for a Self-Management Support Program
Program Location and Extent of Personal Interaction between Coaches and Patients
The Primary Care Model
External On-the-Ground and External Call Center Models
Remote Model
Comparing the Models
Staffing
Content
Patient Population Served
Information Support
Protocols
Staff Training
Communicating with Patients
Communication between Primary Care Physicians and Self-Management Support Staff
Program Evaluation
Evaluation Measures
Measures of Program Structure
Self-Management Support Process Measures
Measures of Patient Knowledge and Self-Efficacy
Measures of Patient Behavior
Measures of Provider Behavior and Guideline Conformance
Measures of Disease Control
Health Outcome Measures
Patient Satisfaction Measures
Utilization and Productivity Measures
Measures of Cost
Combination of Measures
Evaluation Methodology
Conclusions
Keep in Mind that Self-Management Support Programs Aim to Change Patient Behavior
Begin by Considering the Basic Model
Provide Coaching in Addition to Patient Education
Choose Measures for Evaluating the Success of the Program
Looking Ahead
Appendix: Bibliography of Recent Reviews of Self-Management Support Effectiveness
References