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Background
Older Americans are disproportionately affected by an array of chronic conditions, collectively accounting for more than three-quarters of all health expenditures. About 91% of older adults have a least one chronic condition, and 73% have at least two. Data show that as an individuals number of chronic conditions increases, there is a corresponding escalation in adverse outcomes including poor functional status, unnecessary hospitalizations, adverse drug events, duplicative tests, and conflicting medical advice all of which lead to higher health costs and greater outlays for programs like Medicare and Medicaid. People living with chronic conditions only spend about 1% of their time interacting with health professionals. Public policies need to be sensitive to what happens during the time that people are not with their health providers and focus more attention on how better selfmanagement can reduce costs and improve health outcomes and quality of life. Perhaps the best known and most highly regarded self-management program for people with chronic conditions is the Stanford Chronic Disease Self-Management Program (CDSMP). With funding from the Administration on Aging, Centers for Disease Control and Prevention (CDC), and other public and private sources, CDSMP is available across the United States through community-based organizations and via web-based technology. It is also offered in 24 other nations and many languages. CDSMP is a low-cost, evidence-based disease prevention model that utilizes state-of-theart techniques to help those with chronic diseases to manage their conditions, improve their health status, and reduce their need for more costly medical care. The program consists of a series of workshops that are conducted once a week for two and a half hours over six weeks in community settings. The program helps participants develop the skills and coping strategies they need to manage their symptoms through action planning, interactive learning, behavior modeling, problem-solving, decision-making, and social support for change. CDSMP has been shown repeatedly through multiple studies (including randomized control experiments with both English and Spanish speaking populations) to be effective at helping people with all types of chronic conditions to adopt healthy behaviors, improve their health status and reduce their use of hospital stays and emergency room (ER) visits.
March 2012