Who participates in Chronic Disease Self-management (CDSM) programs? Differences between participants and nonparticipants in a population of multimorbid older adults

Melissa Dattalo, Erin R. Giovannetti, Daniel Scharfstein, Chad Boult, Stephen Wegener, Jennifer L. Wolff, Bruce Leff, Kevin D. Frick, Lisa Reider, Katherine Frey, Gary Noronha, Cynthia Boyd

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Self-care management is recognized as a key component of care for multimorbid older adults; however, the characteristics of those most likely to participate in Chronic Disease Self-Management (CDSM) programs and strategies to maximize participation in such programs are unknown. OBJECTIVES: To identify individual factors associated with attending CDSM programs in a sample of multimorbid older adults. RESEARCH DESIGN: Participants in the intervention arm of a matched-pair cluster-randomized controlled trial of the Guided Care model were invited to attend a 6-session CDSM course. Logistic regression was used to identify factors independently associated with attendance. SUBJECTS: All subjects (N=241) were aged 65 years or older, were at high risk for health care utilization, and were not homebound. MEASURES: Baseline information on demographics, health status, health activities, and quality of care was available for CDSM participants and nonparticipants. Participation was defined as attendance at 5 or more CDSM sessions. RESULTS: A total of 22.8% of multimorbid older adults who were invited to CDSM courses participated in 5 or more sessions. Having better physical health (odds ratio [95% confidence interval]=2.3 [1.1-4.8]) and rating one's physician poorly on support for patient activation (odds ratio [95% confidence interval]=2.8 [1.3-6.0]) were independently associated with attendance. CONCLUSIONS: Multimorbid older adults who are in better physical health and who are dissatisfied with their physicians' support for patient activation are more likely to participate in CDSM courses.

Original languageEnglish (US)
Pages (from-to)1071-1075
Number of pages5
JournalMedical care
Volume50
Issue number12
DOIs
StatePublished - Dec 2012

Keywords

  • Guided Care
  • chronic disease
  • geriatrics
  • health promotion
  • selection bias
  • self-management

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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