Effectiveness of chronic disease self-management program for older adults with cardiovascular disease

Abstract Background As the population ages, the prevalence of chronic diseases such as cardiovascular disease (CVD) is expected to increase significantly. Non-pharmacological methods are increasingly being sought to manage cardiovascular disease in the presence of other chronic diseases. The Chronic Disease Self-Management Program (CDSMP) originating over at Stanford University is a group-based education and support program that teaches people with chronic diseases how to manage their conditions and improve their quality of life. Purpose Evaluation of the effectiveness of the 6-week CDSMP workshops among individuals with CVD and chronic illnesses as well as the identification of potential areas for improvement and dissemination of the program. Methods The effectiveness of the workshops was assessed by conducting surveys before the workshops and immediately after the end of the 6-week workshops. The following tools were used to assess the effectiveness: visual analogue scale VAS for the level of pain, fatigue and sleep problems, Mini-COPE questionnaire, The Patient Health Questionnaire (PHQ-9) and the Chronic Disease Self-Efficacy Scales developed by the authors of the program. The results are presented as median and interquartile range (IQR). The Wilcoxon signed-rank test was used to analyze the values before and after the workshops. Results A 64-pts with CVD (60% hypertension) a mean age of 70 years. The participants were predominantly female (90%) and male (10%).The study proved the effectiveness of the workshops. All three indicators measured on an analogue scale improved after 6 weeks of workshops. Pain level decreased from 5 (IQR: 2-6) to 3 (IQR:1-5), p=0.022; fatigue level decreased from 6 (IQR: 4-8) to 5 (IQR: 3-6), p=0.052 and sleep problems from 6 (IQR: 2-7) to 3 (IQR: 1-5), p 0.001. In the Mini-COPE questionnaire, the greatest change was noted in the ability of looking for advice and help from others (p=0.009). There was also a statistically significant decrease in the overall PHQ-9 value: before the workshops the median was 7 (IQR: 3-11), and after the workshops 6 (IQR: 3-9), p=0.034. As for the Chronic Disease Self-Efficacy questionnaire, participants achieved the greatest benefits in the domains of: disease management at a general level, coping with symptoms of the disease and coping with difficult emotions and depressive moods. Conclusion The CDSMP can be a valuable tool for managing these complex issues and improving the health and well-being of older adults with CVD and chronic illnesses.