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CDSMP History

How was the Chronic Disease Self-Management Program developed?

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CDSMP Leader's Manual available in Arabic, Bengali, Chinese, Dutch, French, German, Hindi, Italian, Japanese, Korean, Norwegian, Somali, Turkish, Vietnamese and Welsh


Expert Patients Programme (CDSMP in England)


Licensing information


Organizations licensed to offer the CDSMP


Spanish language CDSMP information

The Division of Family and Community Medicine in the School of Medicine at Stanford University received a five year research grant from the federal Agency for Health Care Research and Policy and the State of California Tobacco-Related Diseases office. The purpose of the research was to develop and evaluate, through a randomized controlled trial, a community-based self-management program that assists people with chronic illness. The study was completed in 1996.

The research project had several investigators: Halsted Holman, M.D., Stanford Professor of Medicine; Kate Lorig, Dr.P.H., Stanford Professor of Medicine; David Sobel, M.D., Regional Director of Patient Education for the Northern California Kaiser Permanente Medical Care Program; Albert Bandura, Ph.D., Stanford Professor of Psychology; and Byron Brown, Jr., Ph.D., Stanford Professor of Health Research and Policy.

The Program was written by Dr. Lorig, V. González, M.P.H., and D. Laurent, M.P.H., all of the Stanford Patient Education Research Center.

The program was based on the experience of the investigators and others with self-efficacy, the confidence one has that he or she can master a new skill or affect one’s own health. The content of the workshop was the result of focus groups with people with chronic disease, in which the participants discussed which content areas were the most important for them.

How was the Program evaluated?

Over 1,000 people with heart disease, lung disease, stroke or arthritis participated in a randomized, controlled test of the CDSMP, and were followed for up to three years. Stanford looked for changes in many areas: health status (disability, social/role limitations, pain and physical discomfort, energy/fatigue, shortness of breath, psychological well-being/distress, depression, health distress, self-rated general health), health care utilization (visits to physicians, visits to emergency department, hospital stays, and nights in hospital), self-efficacy (confidence to perform self-management behaviors, confidence to manage disease in general, confidence to achieve outcomes), and self-management behaviors (exercise, cognitive symptom management, mental stress management/relaxation, use of community resources, communication with physician, and advance directives).

What were the results?

Participants who followed the CDSMP, when compared to those who did not, demonstrated significant improvements in exercise, cognitive symptom management, communication with physicians, self-reported general health, health distress, fatigue, disability, and social/role activities limitations. They also spent fewer days in the hospital, and there was also a trend toward fewer outpatients visits and hospitalizations. These data yield a cost to savings ratio of approximately 1:10. Many of these results persist for as long as three years.

Development in Montreal

In 2007, the Montreal Neurological Institute and Hosputal appointed Dr. Deborah Radcliffe-Branch to implement the Stanford CDSMP in Montreal in English and French. Dr. Radcliffe-Branch launched the program, and undertook the translation of the book "Living a Healthy Life with Chronic Conditions" and program materials into French. My Tool Box/L'atelier thus created the French language option for Stanford, and plays a provincial, national and international role to organizations seeking to implement the program in that language. Our team of leader-trainders include the world's only two Francophone Top Trainers who completed 90 hours of training and over 65 hours of workshop training and facilitation.

Under the guidance of Dr. Deborah Radcliffe-Branch and her team, more than 1900 people have taken the program in both languages in Montréal, and organizations offering the CDSMP in French now exist in Abitibi, Chicoutimi, Lanaudière, Quebec Nord, and the Outaouais regions, for example. My Tool Box/l'Atelier has also assisted organizations in Switzerland and France.


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