The Six-Month and One-Year Outcome of a Chronic Disease Self-Management Program Among Older Adults in Macao: A Quasi-Experimental Study

INTRODUCTION: Promoting older adults to self-manage their chronic conditions is a major focus of the Macao government and healthcare professionals since more than 80% of older adults have suffered chronic conditions. OBJECTIVES: This study evaluated the effect of the Chronic Disease Self-management Program (CDSMP) on self-management behaviors, self-efficacy, health status, and healthcare services utilization among Macao older adults with chronic disease over six months, and assessed whether the intervention effect persisted for one year. METHODS: A longitudinal and quasi-experimental design was used in this study. A total number of 158 older adults with at least one chronic disease were recruited from three Macao community centers. Participants in the study group engaged in a six-session CDSMP in the community centers and participants in the control group received usual care. The Chronic Disease Self-management Questionnaire was used to assess the outcome measures for baseline, six-month and one-year assessment. RESULTS: The age of subjects ranged from 60 to 88, 64.6% had three or more chronic diseases. The results showed that the subjects in the study group had significant improvement in self-management behaviors, self-efficacy, and some health-related indicators at the point of six months, and these improvements were still observable at the point of one year when comparing to the control group. The results also showed that the study group had a decrease in healthcare services utilization, but there was no significant difference between the two groups. CONCLUSION: This study confirmed that the community-dwelling older adults in Macao can acquire positive outcomes in self-management and health-related indicators from the CDSMP. Hence, it is worth promoting this program as a health promotion activity in community.