Evidence map›Paper›PMID 19597169›Full record

Trial reportAnnals of family medicine

Home-based, peer-led chronic illness self-management training: findings from a 1-year randomized controlled trial.

Anthony Jerant, Monique Moore-Hill, Peter Franks

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Self management for patients with chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2014
    Pooled it
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  8. Home-based educational interventions for children with asthma.The Cochrane database of systematic reviews · 2011
    Pooled it
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  19. Increasing access to chronic disease self-management programs in rural and remote communities using telehealth.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2013
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Anthony JerantDepartment of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, California, USA. afjerant@ucdavis.edu
Monique Moore-Hill
Peter Franks

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeStudies suggest peer-led self-management training improves chronic illness outcomes by enhancing illness management self-efficacy. Limitations of most studies, however, include use of multiple outcome measures without predesignated primary outcomes and lack of randomized follow-up beyond 6 months. We conducted a 1-year randomized controlled trial of Homing in on Health (HIOH), a Chronic Disease Self-Management Program variant, addressing these limitations.

methodsWe randomized outpatients (N = 415) aged 40 years and older and who had 1 or more of 6 common chronic illnesses, plus functional impairment, to HIOH delivered in homes or by telephone for 6 weeks or to usual care. Primary outcomes were the Medical Outcomes Study 36-ltem short-form health survey's physical component (PCS-36) and mental component (MCS-36) summary scores. Secondary outcomes included the EuroQol EQ-5D and visual analog scale (EQ VAS), hospitalizations, and health care expenditures.

resultsCompared with usual care, HIOH delivered in the home led to significantly higher illness management self-efficacy at 6 weeks (effect size = 0.27; 95% CI, 0.10-0.43) and at 6 months (0.17; 95% CI, 0.01-0.33), but not at 1 year. In-home HIOH had no significant effects on PCS-36 or MCS-36 scores and led to improvement in only 1 secondary outcome, the EQ VAS (1-year effect size = 0.40; CI, 0.14-0.66). HIOH delivered by telephone had no significant effects on any outcomes.

conclusionsDespite leading to improvements in self-efficacy comparable to those in other CDSMP studies, in-home HIOH had a limited sustained effect on only 1 secondary health status measure and no effect on utilization. These findings question the cost-effectiveness of peer-led illness self-management training from the health system perspective.

Indexed as

Activities of Daily LivingChronic DiseaseDisease ManagementFemaleHome Care ServicesHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient Education as TopicPeer GroupSelf CareSelf EfficacySocioeconomic Factors

Identifiers

PMID19597169
PMCPMC2713168

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.