The role of disease management programs in the health behavior of chronically ill patients

• Published in: Patient education and counseling Vol. 95; no. 1; pp. 137 - 142
• Main Authors: Cramm, Jane Murray, Adams, Samantha A, Walters, Bethany Hipple, Tsiachristas, Apostolos, Bal, Roland, Huijsman, Robbert, Rutten-Van Mölken, Maureen P.M.H, Nieboer, Anna Petra
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.04.2014
• Subjects: Adult; Aged; Aged, 80 and over; Chronic care; Chronic Disease - therapy; Chronic sickness; Disease Management; Female; Health Behavior; Health behaviour; Humans; Integrated care; Internal Medicine; Interviews as Topic; Male; Middle Aged; Motor Activity; National Health Programs - statistics & numerical data; Nursing; Outcome and Process Assessment (Health Care); Physical activity; Program Evaluation; Project managers; Qualitative Research; Quality of Life; Smoking; Socioeconomic Factors; Surveys and Questionnaires; Netherlands; Chronic care; Integrated care; Disease management; Health behavior; Quality of life
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2013.12.017

Abstract Objective Investigate the effects of disease management program (DMP) implementation on physical activity, smoking, and physical quality of life among chronically ill patients. Methods This study used a mixed-methods approach involving qualitative (35 interviews with project managers) and quantitative (survey of patients from 18 DMPs) data collection. Questionnaire response rates were 51% (2010; 2619/5108) at T 0 and 47% (2011; 2191/4693) at T 1. Results Physical activity and the percentage of smokers improved significantly over time, whereas physical quality of life declined. After adjusting for patients’ physical quality of life at T 0, age, educational level, marital status, and gender, physical activity at T 0 ( p < 0.01), changes in physical activity ( p < 0.001), and percentage of smokers at T 0 ( p < 0.05) predicted physical quality of life at T 1. Project managers reported that DMPs improved patient–professional interaction. The ability to set more concrete targets improved patients’ health behaviors. Conclusions DMPs appear to improve physical activity among chronically ill patients over time. Furthermore, (changes in) health behavior are important for the physical quality of life of chronically ill patients. Practice implications Redesigning care systems and implementing DMPs based on the chronic care model may improve health behavior among chronically ill patients.