Interventions used in disease management programmes for patients with chronic illness-which ones work? Meta-analysis of published reports
Open accessAbstract
OBJECTIVE: To systematically evaluate the published evidence regarding the characteristics and effectiveness of disease management programmes. DESIGN: Meta-analysis. DATA SOURCES: Computerised databases for English language articles during 1987-2001. STUDY SELECTION: 102 articles evaluating 118 disease management programmes. MAIN OUTCOME MEASURES: Pooled effect sizes calculated with a random effects model. RESULTS: Patient education was the most commonly used intervention (92/118 programmes), followed by education of healthcare providers (47/118) and provider feedback (32/118). Most programmes (70/118) used more than one intervention. Provider education, feedback, and reminders were associated with significant improvements in provider adherence to guidelines (effect sizes (95% confidence intervals) 0.44 (0.19 to 0.68), 0.61 (0.28 to 0.93), and 0.52 (0.35 to 0.69) respectively) and with significant improvements in patient disease control (effect sizes 0.35 (0.19 to 0.51), 0.17 (0.10 to 0.25), and 0.22 (0.1 to 0.37) respectively). Patient education, reminders, and financial incentives were all associated with improvements in patient disease control (effect sizes 0.24 (0.07 to 0.40), 0.27 (0.17 to 0.36), and 0.40 (0.26 to 0.54) respectively). CONCLUSIONS: All studied interventions were associated with improvements in provider adherence to practice guidelines and disease control. The type and number of interventions varied greatly, and future studies should directly compare different types of intervention to find the most effective.
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Ongoing contact has been demonstrated to improve long-term adherence to behavior change.
“ongoing contact that has been demonstrated so often to improve long-term adherence to behavior change [55–58].”
From SMART trial: A randomized clinical trial of self-monitoring in behavioral weight management-design and baseline findings (2009) · cites this paper as [58]
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- Authors
- Weingarten, S. R.
- Corresponding author
- Weingarten, S. R
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2002-10-26
- Volume
- 325
- Issue
- 7370
- Pages
- 925-925
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC130055
- OpenAlex
- W2134631016
- Cited by
- 735
- References
- 106
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 6 · 2023: 20 · 2022: 13 · 2021: 12 · 2020: 8 · 2019: 16 · 2018: 16 · 2017: 32 · 2016: 32 · 2015: 35 · 2014: 33 · 2013: 42 · 2012: 35
- FWCI
- 7.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- disease management programs, chronic disease, patient education, health professions education, provider feedback, reminders, financial incentives, guideline adherence, disease control, intervention effectiveness
- MeSH terms
- Chronic Disease, Clinical Trials as Topic, Feedback, Humans, Patient Education as Topic, Practice Guidelines as Topic, Guideline Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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