Self-management: one size does not fit all.

Self-management for people with chronic diseases is now widely recognized as an essential part of treatment. Despite the high expectations and the growing body of evidence in terms of its effectiveness, a wide application of self-management programs is inhibited due to several challenges. Worldwide, a variety of complex and multifactorial interventions have been evaluated in very heterogeneous patient populations leaving healthcare professionals in doubt about what works best and what works in whom. In this letter to the editor the authors systematically reflect on the current evidence of patient-specific determinants of success of self-management and argument the urge for increased scientific efforts to establish tailored self-management in patients with chronic disease.

[1]  J. Cade,et al.  Group based training for self-management strategies in people with type 2 diabetes mellitus. , 2005, The Cochrane database of systematic reviews.

[2]  L. Welschen,et al.  Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. , 2012, The Cochrane database of systematic reviews.

[3]  Changrong Yuan,et al.  Self-management programs for chronic musculoskeletal pain conditions: a systematic review and meta-analysis. , 2011, Patient education and counseling.

[4]  B. Lundman,et al.  Improvements in HbA1c remain after 5 years--a follow up of an educational intervention focusing on patients' personal understandings of type 2 diabetes. , 2008, Diabetes research and clinical practice.

[5]  Werner Vach,et al.  Mediating the effect of self-care management intervention in type 2 diabetes: a meta-analysis of 47 randomised controlled trials. , 2010, Patient education and counseling.

[6]  Sally Morton,et al.  Meta-Analysis: Chronic Disease Self-Management Programs for Older Adults , 2005, Annals of Internal Medicine.

[7]  Stephen Colagiuri,et al.  Individual patient education for people with type 2 diabetes mellitus. , 2009, The Cochrane database of systematic reviews.

[8]  L. Stewart,et al.  Practical methodology of meta-analyses (overviews) using updated individual patient data. Cochrane Working Group. , 1995, Statistics in medicine.

[9]  Grant D. Huang,et al.  A Comprehensive Care Management Program to Prevent Chronic Obstructive Pulmonary Disease Hospitalizations , 2012, Annals of Internal Medicine.

[10]  E. Walters,et al.  Self-management education for patients with chronic obstructive pulmonary disease. , 2007, The Cochrane database of systematic reviews.

[11]  Thomas Bodenheimer,et al.  Improving primary care for patients with chronic illness. , 2002, JAMA.

[12]  K. Lorig,et al.  Self-management education: History, definition, outcomes, and mechanisms , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[13]  Rajeev Chaudhry,et al.  A randomized controlled trial of telemonitoring in older adults with multiple health issues to prevent hospitalizations and emergency department visits. , 2012, Archives of internal medicine.

[14]  J. Bourbeau,et al.  Self-management and behaviour modification in COPD . , 2004, Patient education and counseling.

[15]  K. Khunti,et al.  Effectiveness of a diabetes education and self management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus: three year follow-up of a cluster randomised controlled trial in primary care , 2012, BMJ : British Medical Journal.

[16]  M. Porta,et al.  A 5-year randomized controlled study of learning, problem solving ability, and quality of life modifications in people with type 2 diabetes managed by group care. , 2004, Diabetes care.

[17]  Aleksandra Jovicic,et al.  Effects of Self-Management Intervention on Health Outcomes of Patients with Heart Failure: A Systematic Review of Randomized Controlled Trials , 2006 .

[18]  J Cleland,et al.  Glasgow supported self-management trial (GSuST) for patients with moderate to severe COPD: randomised controlled trial , 2012, BMJ : British Medical Journal.

[19]  C. Mathers,et al.  Projections of Global Mortality and Burden of Disease from 2002 to 2030 , 2006, PLoS medicine.

[20]  E H Wagner,et al.  Chronic disease management: what will it take to improve care for chronic illness? , 1998, Effective clinical practice : ECP.

[21]  Ann C. Greiner,et al.  The 1st Annual Crossing the Quality Chasm Summit: A Focus on Communities , 2004 .

[22]  A. Bauman,et al.  Self-management education and regular practitioner review for adults with asthma. , 2000, The Cochrane database of systematic reviews.

[23]  C. Wright,et al.  Self-management approaches for people with chronic conditions: a review. , 2002, Patient education and counseling.

[24]  D. Fitzmaurice,et al.  Self-monitoring and self-management of oral anticoagulation. , 2010, The Cochrane database of systematic reviews.

[25]  J. Knottnerus,et al.  How should we define health? , 2011, BMJ : British Medical Journal.

[26]  Brian T. Austin,et al.  Organizing care for patients with chronic illness. , 1996, The Milbank quarterly.

[27]  S. Newman,et al.  Self-management interventions for chronic illness , 2004, The Lancet.