1. Effect of Changes in Patient’s Self-management Strategies on Clinical Outcomes: Evidence from a Cohort Study of Patients with Diabetes, Hypertension, and Hyperlipidemia
- Author
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Yong Jin Kim, Eun Kyo Kang, Young Ho Yun, Ye Eun Rhee, Hae Young Lee, Sang Min Park, Kyae Hyung Kim, Young Min Cho, and Soojeong Kim
- Subjects
medicine.medical_specialty ,030505 public health ,Self-management ,business.industry ,Diastole ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Blood pressure ,Internal medicine ,Diabetes mellitus ,Hyperlipidemia ,medicine ,030212 general & internal medicine ,0305 other medical science ,Prospective cohort study ,business ,Applied Psychology ,Dyslipidemia ,Cohort study - Abstract
Self-management has become the dominant care model for chronic disease management. This study aimed to investigate the effect of changes in self-management strategies on the clinical outcomes of chronic diseases. Two hundred ninety-seven patients with one or more chronic disease (diabetes, dyslipidemia, or hypertension) were registered and followed in this prospective cohort study. We compared differences in the changes in clinical outcomes from baseline to 6 months according to the improvement of self-management strategies by analysis of covariance. Diabetic patients with improved self-management strategies showed a significantly greater change in HbA1c levels compared to patients without improvement of self-management strategies (group difference in HbA1c = 0.51%). In hypertensive patients, systolic and diastolic blood pressure (BP) showed a significant decline in the patients with improved self-management strategies (group difference in systolic BP = 6.2 mmHg and in diastolic BP = 5.5 mmHg). Clinical outcomes improved significantly when self-management strategies improved in people with a poor self-management strategy at baseline. This study suggests that improvements in self-management strategies are associated with an improvement in clinical outcomes among patients with chronic diseases, especially for those with an initially poor self-management strategy.
- Published
- 2020