Staff Information

Chronic Disease Self-Management Program (CDSMP)  

A consistent struggle for providers and healthcare organizations is how to effectively teach patients to better manage their chronic disease(s). Whether the patient has asthma, diabetes, hypertension, arthritis or COPD, people with chronic conditions have similar concerns and problems, and, they must deal not only with their diseases, but also with the impact these have on their lives and emotions. Stanford University’s School of Medicine has developed an evidence-based Chronic Disease Self-Management Program that has gained worldwide recognition as a proven methodology that teaches people with chronic conditions how to effectively manage their illnesses. Participants who complete the workshop feel better, are less limited by their illness, and have better health outcomes and less healthcare utilization. 

CUP’s Chronic Disease Self-Management Program Living a Healthy Life with Chronic Conditions

CUP has received a licensing agreement from Stanford and the requisite Leader training for several CUP staff members to teach the Program and is pleased to announce ongoing workshops. Workshop dates and times are established when a sufficient number of members are registered to hold a workshop. The workshop and participant workbook are free to CUP members.

Workshop Registration and Provider Referral Process

CUP members may register for the class by calling CUP at (360) 449-8925. CUP has also developed a "prescription pad" providers may use to refer CUP members to the workshop. Simply tear-off the sheet and give it to your CUP patient. You may wish to encourage the patient by saying: “I recommend that you call CUP about this self-management workshop.”Click here to view the prescription pad. Please call Sue Ybarrondo at (360) 449-8925 if you would like copies of the prescription pad and/or our CDSMP brochure for your practice. To view the CDSMP brochure, click here.

What Your CUP Patients Will Learn

The Chronic Disease Self-Management Program is a workshop that meets for 2 ½ hours a week, for six-weeks where people with different chronic diseases attend together. Workshops are facilitated by two trained leaders, one or both of whom are peers with chronic conditions themselves. Sessions are highly participatory, where mutual support and success builds the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives. Subjects covered include:

1) techniques to deal with problems such as frustration, fatigue, pain, and isolation, 2) appropriate exercise for maintaining and improving strength, flexibility, and endurance, 3) appropriate use of medications, 4) communicating effectively with family, friends, and health professionals, 5) nutrition, 6) making informed treatment decisions, and, 7) making action plans.

Participant Workbook

Each participant receives a copy of Living a Healthy Life with Chronic Conditions. The book includes chapters on many of the topics discussed during the workshops and is a handy reference for participants after they complete the class.

Does the Program Replace Existing Programs and Treatments?

The Self-Management Program will not conflict with existing programs or treatment. It is designed to enhance regular treatment and disease-specific education.

How was the Program Developed?

The Division of Family and Community Medicine in the Department of Medicine at Stanford University received a five-year research grant from the federal Agency for Health Care Research and Policy and the State of California Tobacco-Related Research Project. The purpose of the research was to develop and evaluate, through a randomized controlled trial, a community-based self-management program that assists people with chronic illness. The study was completed in 1996. The content of the workshop was the result of focus groups with people with chronic health problems, in which the participants discussed which content areas were the most important for them.

The research project had several investigators: Halsted Holman, M.D., Stanford Professor of Medicine; Kate Lorig, Dr.P.H., Stanford Professor of Medicine; David Sobel, M.D., Regional Director of Patient Education for the Northern California Kaiser Permanente Medical Care Program; Albert Bandura, Ph.D., Stanford Professor of Psychology; and Byron Brown, Jr., Ph.D., Stanford Professor of Health Research and Policy. The Program was written by Dr. Lorig, Virginia González, M.P.H., and Diana Laurent, M.P.H., all of the Stanford Patient Education Research Center. Ms. González and Ms. Laurent also served as integral members of the research team.

The process of the program was based on the experience of the investigators and others with self-efficacy, the confidence one has that he or she can master a new skill or affect one’s own health. The content of the workshop was the result of focus groups with people with chronic disease, in which the participants discussed which content areas were the most important for them.

How was the Program Evaluated?

Over 1,000 people with heart disease, lung disease, stroke or arthritis participated in a randomized, controlled test of the Program, and were followed for up to three years. Changes were assessed in many areas: health status (disability, social/role limitations, pain and physical discomfort, energy/fatigue, shortness of breath, psychological well-being/distress, depression, health distress, self-rated general health), health care utilization (visits to physicians, visits to emergency department, hospital stays, and nights in hospital), self-efficacy (confidence to perform self-management behaviors, confidence to manage disease in general, confidence to achieve outcomes), and self-management behaviors (exercise, cognitive symptom management, mental stress management/relaxation, use of community resources, communication with physician, and advance directives).

What Were the Results?

Participants who took the Program, when compared to those who did not, demonstrated significant improvements in exercise, cognitive symptom management, communication with physicians, self-reported general health, health distress, fatigue, disability, and social/role activities limitations. They also spent fewer days in the hospital, and there was also a trend toward fewer outpatient visits and hospitalizations. These data yield a cost to savings ratio of approximately 1:10. Many of these results persist for as long as three years.

Program Dissemination

The Program has been adopted by such groups as the National Health Service of England and the Diabetes Society of British Columbia in Canada, as well as parts of Australia, Japan, Norway, Sweden, New Zealand, St. Lucia and Hong Kong. In the Northwest, several healthplans offer the program, including Kaiser Permanente, Group Health Cooperative of Puget Sound and PacificSource.

Questions?

Please direct questions about the Program and referral process to Cheryl Bailey-Horner  at (360) 449-8926 or via e-mail to cbhorner@cuphealth.com.