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Chronic Illness
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The expert patients programme online, a 1-year study of an Internet-based self-management programme for people with long-term conditions

Kate R. Lorig

Stanford University School of Medicine, Stanford Patient Education Research Center, 1000 Welch Rd, Palo Alto, CA 94306, USA

Philip L. Ritter

Stanford University School of Medicine, Stanford Patient Education Research Center, 1000 Welch Rd, Palo Alto, CA 94306, USA, philr{at}stanford.edu

Ayesha Dost

Department of Health, 7E58 Quarry House, Leeds, LS2 7UE, UK

Kathryn Plant

Stanford University School of Medicine, Stanford Patient Education Research Center, 1000 Welch Rd, Palo Alto, CA 94306, USA

Diana D. Laurent

Stanford University School of Medicine, Stanford Patient Education Research Center, 1000 Welch Rd, Palo Alto, CA 94306, USA

Ian Mcneil

Department of Health, 2 Priory Road, Beauly, Inverness-shire, IV4 7GD, UK

Objectives: Evaluate the effectiveness of an online self-management programme (EPP Online) for England residents with long-term conditions.

Methods: A prospective longitudinal study. Data were collected online at baseline, 6 and 12 months. The intervention was an asynchronous 6-week chronic-disease self-management programme offered online. We measured seven health status measures (health distress, self-rated health, illness intrusiveness, disability, fatigue, pain and shortness of breath), four behaviours (aerobic exercise, stretching exercise, stress management and communications with physician), and five utilization measures (GP visits, pharmacy visits, PT/OT visits, emergency visits and hospitalizations). We also measured self-efficacy and satisfaction with the health care system.

Results: A total of 568 completed baseline data: 546 (81%) completed 6 months and 443 (78%) completed 1 year. Significant improvements (p<0.01) were found at 6 months for all variables except self-rated health, disability, stretching, hospitalizations and nights in hospital. At 12 months only decrease in disability, nights in hospital and hospitalizations were not significant with reduction in visits to emergency departments being marginally significant (p = 0.012). Both self-efficacy and satisfaction with the health care system improved significantly.

Discussion: The peer-led online programme conditions appears to decrease symptoms, improve health behaviours, self-efficacy and satisfaction with the health care system and reducing health care utilization up to 1 year.

Key Words: Self-management • Patient education • Chronic disease

Chronic Illness, Vol. 4, No. 4, 247-256 (2008)
DOI: 10.1177/1742395308098886
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