Evaluation of a large-scale implementation of disease management programmes in various Dutch regions: first results

Background: Disease management programmes (DMPs) aim to level off the rising trend in chronic diseases, to prevent or postpone complications and co-morbidities and above all to increase the level of self-management and quality of life of chronically-ill patients. Although evidence on the cost-effectiveness of DMPs is partly available, many questions still remain. Benefits of disease management in a range of DMPs on the patient, professional and organisational level are evaluated by capturing the results in a single conceptual framework, employing comparable structure, process, and outcome measures. First results of cardiovascular DMPs are presented. Methods: To describe the cardiovascular DMPs we used a methodological approach that combines qualitative and quantitative (mixed) research methods, enabling a thorough and comprehensive evaluation of complex cardiovascular programmes. Results: Our study showed that each cardiovascular DMP consists of a combination of patient-related, professional, and organizational interventions. The exact programme components for each programme vary, however. Conclusion: Our results showed that disease management level, costs, health care utilization, patient characteristics, health behaviours, self-management abilities, and health of CVD patients all varied widely between the cardiovascular DMPs. These variations are expected to influence outcomes and cost-effectiveness of the cardiovascular DMPs.