Self‐management education programmes by lay leaders for people with chronic conditions

摘要: Lay-led self-management programmes are becoming widespread in the attempt to promote self-care for people with chronic conditions. Objectives To assess systematically effectiveness of lay-led Randomised controlled trials (RCTs) comparing structured education conditions against no intervention or clinician-led were used. We included seventeen involving 7442 participants. The interventions shared similar structures and components but studies showed heterogeneity studied, outcomes collected effects. There children adolescents, only one study provided data on beyond six months, two reported clinical outcomes. Primary Health status: was a small, statistically-significant reduction in: pain (11 studies, SMD -0.10 (95% confidence interval (CI) -0.17 -0.04)); disability (8 -0.15 CI -0.25 -0.05); fatigue (7 -0.16 -0.23 -0.09); improvement depression (6 95% -0.24 -0.07). small (but not statistically- clinically-significant) psychological well-being (5 studies; -0.12 -0.33 0.09)); difference between groups health-related quality life (3 WMD -0.03 -0.09 0.02). Six self-rated general health (WMD -0.20 -0.31 -0.10). behaviours: 7 increase self-reported aerobic exercise (SMD -0.27 -0.12)) moderate cognitive symptom management (4 -0.55 ( -0.85 -0.26)). Healthcare use: differences physician practitioner attendance (9 0.04)). also days/nights spent hospital -0.32 -0.71 0.07)). Self-efficacy: (confidence manage condition) (10 studies): -0.30, -0.41 -0.19. No adverse events any studies.