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Randomized Controlled Trial
. 2005 Nov;55(520):831-7.

Randomised controlled trial of a lay-led self-management programme for Bangladeshi patients with chronic disease

Chris Griffiths  1 , Justhna Motlib, Abdul Azad, Jean Ramsay, Sandra Eldridge, Gene Feder, Rowshan Khanam, Rafia Munni, Myra Garrett, Andy Turner, Julia Barlow
Affiliations
Randomized Controlled Trial

Randomised controlled trial of a lay-led self-management programme for Bangladeshi patients with chronic disease

Chris Griffiths et al. Br J Gen Pract. 2005 Nov.

Abstract

Background: Reducing the impact of chronic disease in minority ethnic groups is an important public health challenge. Lay-led education may overcome cultural and language barriers that limit the effectiveness of professionally-led programmes. We report the first randomised trial of a lay-led self-management programme - the Chronic Disease Self-Management Programme (CDSMP) (Expert Patient Programme) - in a south Asian group.

Aim: To determine the effectiveness of a culturally-adapted lay-led self-management programme for Bangladeshi adults with chronic disease.

Design of study: Randomised controlled trial.

Setting: Tower Hamlets, east London.

Method: We recruited Bangladeshi adults with diabetes, cardiovascular disease, respiratory disease or arthritis from general practices and randomised them to the CDSMP or waiting-list control. Self-efficacy (primary outcome), self-management behaviour, communication with clinician, depression scores, and healthcare use were assessed by blinded interviewer-administered questionnaires in Sylheti before randomisation and 4 months later.

Results: Of the 1363 people invited, 476 (34%) agreed to take part and 92% (439/476) of participants were followed up. The programme improved self-efficacy (difference: 0.67, 95% confidence interval [CI] = 0.08 to 1.25) and self-management behaviour (0.53; 95% CI = 0.01 to 1.06). In the 51% (121/238) of intervention participants attending three or more of the 6-weekly education sessions the programme led to greater improvements in self-efficacy (1.47; 95% CI = 0.50 to 1.82) and self-management behaviour (1.16; 95% CI = 0.50 to 1.82), and reduced HADS depression scores (0.64; 95% CI = 0.07 to 1.22). Communication and healthcare use were not significantly different between groups. The programme cost pound123 (181) per participant.

Conclusion: A culturally-adapted CDSMP improves self-efficacy and self-care behaviour in Bangladeshi patients with chronic disease. Effects on health status were marginal. Benefits were limited by moderate uptake and attendance.

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Figures

Figure 1
Figure 1
Participant flow. Effectiveness of a lay-led self-management programme for Bangladeshis in the UK with chronic disease: A randomised controlled trial.
See this image and copyright information in PMC

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