Marjolijn I Bal1, Jane N T Sattoe2, Pepijn D D M Roelofs3, Roland Bal4, AnneLoes van Staa5, Harald S Miedema6. 1. Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands. Electronic address: m.i.bal@hr.nl. 2. Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands. Electronic address: j.n.t.sattoe@hr.nl. 3. Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands. Electronic address: p.d.d.m.roelofs@hr.nl. 4. Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands. Electronic address: r.bal@bmg.eur.nl. 5. Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management, Rotterdam, The Netherlands. Electronic address: a.van.staa@hr.nl. 6. Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands. Electronic address: h.s.miedema@hr.nl.
Abstract
OBJECTIVE: To systematically explore the effectiveness and effective components of self-management interventions. METHODS: Study selection criteria were: Original articles in English published between 2003 and 2015; focusing on youth with chronic conditions; describing self-management interventions; with clear outcome measures; using RCT design. The random effects analysis was applied in which standardized mean differences per study were calculated. RESULTS: 42 RCTs were included. Interventions focused on medical management, provided individually in clinical settings or at home by mono-disciplinary teams showed a trend in improving adherence. Interventions delivered individually at home by mono-disciplinary teams showed a trend in improving dealing with a chronic condition. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Adherence could be improved through interventions focused on medical management, provided individually in a clinical or home setting by a mono-disciplinary team. Interventions focused on dealing with a chronic condition might be provided individually, through telemedicine programs facilitating peer-support. These intervention elements seemed effective irrespective of diagnosis, and may therefore act as good starting points for further research into and for improvement of self-management support for youth with chronic conditions in pediatric care. Results underlined the need to systematically develop and evaluate self-management interventions, since this may provide more evidence for effectiveness and effective intervention components.
OBJECTIVE: To systematically explore the effectiveness and effective components of self-management interventions. METHODS: Study selection criteria were: Original articles in English published between 2003 and 2015; focusing on youth with chronic conditions; describing self-management interventions; with clear outcome measures; using RCT design. The random effects analysis was applied in which standardized mean differences per study were calculated. RESULTS: 42 RCTs were included. Interventions focused on medical management, provided individually in clinical settings or at home by mono-disciplinary teams showed a trend in improving adherence. Interventions delivered individually at home by mono-disciplinary teams showed a trend in improving dealing with a chronic condition. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Adherence could be improved through interventions focused on medical management, provided individually in a clinical or home setting by a mono-disciplinary team. Interventions focused on dealing with a chronic condition might be provided individually, through telemedicine programs facilitating peer-support. These intervention elements seemed effective irrespective of diagnosis, and may therefore act as good starting points for further research into and for improvement of self-management support for youth with chronic conditions in pediatric care. Results underlined the need to systematically develop and evaluate self-management interventions, since this may provide more evidence for effectiveness and effective intervention components.
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