HEALTH CARE PROVIDER-DRIVEN PATIENT EDUCATION FOR SELF-MANAGEMENT IN CHRONIC DISEASES: A SYSTEMATIC REVIEW OF THE EVIDENCE
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Keywords
Patient education, self-management, chronic diseases, health care providers, systematic review, randomized controlled trials, therapeutic education
Abstract
Background: Chronic diseases, responsible for over 70% of global mortality, necessitate effective self-management to improve patient outcomes and reduce healthcare burdens (World Health Organization, 2020). Health care provider-driven patient education, particularly therapeutic patient education (TPE), is a promising strategy to enhance self-management skills, yet its effectiveness across diverse chronic conditions remains under-synthesized. This systematic review evaluates the impact of provider-driven education on self-management outcomes in adults with chronic diseases. Methodology: Following PRISMA guidelines, we searched PubMed, Web of Science, and Cochrane Library from inception to September 2024, identifying 55 randomized controlled trials (RCTs) involving 20,456 adults with chronic conditions (e.g., diabetes, hypertension, COPD). Inclusion criteria targeted provider-delivered (physicians, nurses, or multidisciplinary teams) interventions focusing on knowledge, skill-building, and behavioral support, with outcomes like self-efficacy, adherence, clinical markers, and quality of life. Data were extracted using Covidence, and random-effects meta-analysis calculated standardized mean differences (SMDs) for continuous outcomes, with heterogeneity assessed via I². Results: Interventions, primarily group-based (42%) or nurse-led (52%), showed moderate improvements across outcomes: self-efficacy (SMD = 0.50, 95% CI: 0.37–0.63; I² = 59%), treatment adherence (SMD = 0.68, 95% CI: 0.47–0.89; I² = 52%), quality of life (SMD = 0.42, 95% CI: 0.29–0.55; I² = 67%), and clinical markers (e.g., HbA1c -0.8%, systolic BP -7 mmHg; SMD = -0.46, 95% CI: -0.59 to -0.33; I² = 65%). Group formats and nurse-led interventions yielded stronger effects. Heterogeneity and limited long-term data were noted. Conclusion: Patient education driven by healthcare providers significantly enhances self-management in chronic diseases, with group-based and nurse-led formats showing superior outcomes. Standardized protocols and further research on long-term sustainability and equity are needed to optimize implementation.
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