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Patient self-management support: novel strategies in hypertension and heart disease.

Cardiol Clin. 2010 Nov;28(4):655-63. Bosworth HB, Powers BJ, Oddone EZ. Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, HSR&D (152), Suite 600, 411 West Chapel Hill Street, Durham, NC 27701, USA; Division of General Internal Medicine, Department of Medicine, Duke University, 2424 Erwin Road, Hock Plaza, Durham, NC 27703, USA.

Cardiovascular diseases (CVDs) have become the leading cause of death and disability in most countries in the world. This article addresses how patient self-management is a crucial component of effective high-quality health care for hypertension and CVD. The patient must be a collaborator in this process, and methods of improving patients' ability and confidence for self-management are needed. Successful self-management programs have often supplemented the traditional patient-physician encounter by using nonphysician providers, remote patient encounters (telephone or Internet), group settings, and peer support for promoting self-management. Several factors need to be considered in self-management.

Given the health care system's inability to achieve several quality indicators using traditional office-based physician visits, further consideration is needed to determine the degree to which these interventions and programs can be integrated into primary care, their effectiveness in different groups, and their sustainability for improving chronic disease care.

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