Patients with chronic conditions make day-to-day decisions about—self-manage—their
illnesses. This reality introduces a new chronic disease paradigm: the patient-professional
partnership, involving collaborative care and self-management education. Self-management
education complements traditional patient education in supporting patients
to live the best possible quality of life with their chronic condition. Whereas
traditional patient education offers information and technical skills, self-management
education teaches problem-solving skills. A central concept in self-management
is self-efficacy—confidence to carry out a behavior necessary to reach
a desired goal. Self-efficacy is enhanced when patients succeed in solving
patient-identified problems. Evidence from controlled clinical trials suggests
that (1) programs teaching self-management skills are more effective than
information-only patient education in improving clinical outcomes; (2) in
some circumstances, self-management education improves outcomes and can reduce
costs for arthritis and probably for adult asthma patients; and (3) in initial
studies, a self-management education program bringing together patients with
a variety of chronic conditions may improve outcomes and reduce costs. Self-management
education for chronic illness may soon become an integral part of high-quality
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