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The Stanford Chronic Disease Self-Management Program (CDSMP)

The Stanford Chronic Disease Self-Management Program (CDSMP)

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Resource from PFCD's Dec. 11th event.

Resource from PFCD's Dec. 11th event.

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Published by: Partnership to Fight Chronic Disease on Dec 13, 2012
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01/10/2014

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The Stanford Chronic Disease Self-Management Program(CDSMP)
Background
Older Americans are disproportionately affected by an array of chronic conditions,collectively accounting for more than three-quarters of all health expenditures.
 
About 91%of older adults have a least one chronic condition, and 73% have at least two. Data show
that as an individual’s number of chronic conditions increases, there is a corresponding
escalation in adverse outcomes including poor functional status, unnecessaryhospitalizations, adverse drug events, duplicative tests, and conflicting medical advice
 – 
allof which lead to higher health costs and greater outlays for programs like Medicare andMedicaid.People living with chronic conditions only spend about 1% of their time interacting withhealth professionals. Public policies need to be sensitive to what happens during the timethat people are not with their health providers and focus more attention on how better self-management can reduce costs and improve health outcomes and quality of life. Perhapsthe best known and most highly regarded self-management program for people withchronic conditions is the Stanford Chronic Disease Self-Management Program (CDSMP).With funding from the Administration on Aging, Centers for Disease Control andPrevention (CDC), and other public and private sources, CDSMP is available across theUnited States through community-based organizations and via web-based technology. It isalso offered in 24 other nations and many languages.CDSMP is a low-cost, evidence-based disease prevention model that utilizes state-of-the-art techniques to help those with chronic diseases to manage their conditions, improvetheir health status, and reduce their need for more costly medical care. The programconsists of a series of workshops that are conducted once a week for two and a half hoursover six weeks in community settings. The program helps participants develop the skillsand coping strategies they need to manage their symptoms through action planning,interactive learning, behavior modeling, problem-solving, decision-making, and socialsupport for change.CDSMP has been shown repeatedly through multiple studies (including randomizedcontrol experiments with both English and Spanish speaking populations) to be effectiveat helping people with all types of chronic conditions to adopt healthy behaviors, improvetheir health status and reduce their use of hospital stays and emergency room (ER) visits.
 
2
Evidence of CDSMP Effectiveness
A key feature of CDSMP is the strength of evidence about its impact. Based on a review of major published studies, CDSMP results in significant, measurable improvements in healthand quality of life for people with chronic conditions. These include considerable upgradesin health status, self-efficacy, and psychological well-being; increased physical activity;fewer social role limitations and reduced fatigue; and enhanced partnerships withphysicians. Research on cost savings has also shown impressive results:
 
One U.S. study published in
 Medical Care
found a 2.5 visit reduction in ER andoutpatient visits per participant over 2 years, and a 0.49 day reduction inhospitalizations in the first 6 months of the study.
 
 
Another U.S. study published in
 Effective Clinical Practice
of CDSMP participantsrecruited from Kaiser Permanente hospitals and clinics and the Group HealthCooperative of Puget Sound found that, over a 1-year period, participants had a mean0.97 day reduction in hospitalization and averaged 0.2 fewer ER visits. This suggestsan estimated savings of about $1,000 per participant in the first year.
 
In a 2010 United Kingdom study, 50% of CDSMP participants reported fewerunscheduled visits to their primary care physician, and 35% reported reducing theamount of medication they used after attending CDSMP. Total cost savings wereapproximately $2,934 per CDSMP participant per year.
 
According to a 2008 Lewin Group analysis, improving access to CDSMP could saveMedicare approximately $280 million per year, or almost $1.5 billion over 10 years.

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