Predicting who will benefit from an Expert Patients Programme self-management course.

Area of Science:

• Health Services Research
• Chronic Disease Management
• Patient Self-Management

Background:

• The Expert Patients Programme (EPP) in England is a lay-led course designed to enhance self-care skills for individuals with long-term conditions.
• While the EPP has shown effectiveness in improving subjective health, predictors of its impact remain unclear.
• The course attracts a diverse patient population with varying self-defined long-term conditions.

Purpose of the Study:

• To identify baseline patient characteristics that predict clinical outcomes following participation in a chronic disease self-management course.
• To evaluate if identifying these characteristics can help target the course to individuals likely to gain the most benefit.

Main Methods:

• A post-hoc subgroup analysis was conducted on data from a randomized controlled trial.
• The analysis explored predictors of self-efficacy, energy levels, and health-related quality of life.
• Multiple regression examined interactions between baseline variables and trial outcomes in 629 participants from community settings across England.

Main Results:

• Significant predictors of positive health outcomes included lower baseline self-efficacy and health-related quality of life.
• Younger participants demonstrated substantially greater benefits compared to older individuals.
• Baseline general health and energy levels also interacted with trial outcomes.

Conclusions:

• Individuals with lower self-efficacy and poorer health at the start of the Expert Patients Programme experienced more significant improvements.
• The EPP may offer a protective effect on health-related quality of life for patients with pre-existing poor health and low confidence.
• Targeting younger patients, those with low confidence, and those coping poorly with their condition may enhance the course's overall positive impact.