RT Journal Article SR Electronic T1 Randomised controlled trial of a lay-led self-management programme for Bangladeshi patients with chronic disease JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP 831 OP 837 VO 55 IS 520 A1 Chris Griffiths A1 Justhna Motlib A1 Abdul Azad A1 Jean Ramsay A1 Sandra Eldridge A1 Gene Feder A1 Rowshan Khanam A1 Rafia Munni A1 Myra Garrett A1 Andy Turner A1 Julia Barlow YR 2005 UL http://bjgp.org/content/55/520/831.abstract AB Background Reducing the impact of chronic disease in minority ethnic groups is an important public health challenge. Lay-led education may overcome cultural and language barriers that limit the effectiveness of professionally–led programmes. We report the first randomised trial of a lay-led self-management programme — the Chronic Disease Self-Management Programme (CDSMP) (Expert Patient Programme) — in a south Asian group.Aim To determine the effectiveness of a culturally-adapted lay–led self-management programme for Bangladeshi adults with chronic disease.Design of study Randomised controlled trial.Setting Tower Hamlets, east London.Method We recruited Bangladeshi adults with diabetes, cardiovascular disease, respiratory disease or arthritis from general practices and randomised them to the CDSMP or waiting-list control. Self-efficacy (primary outcome), self-management behaviour, communication with clinician, depression scores, and healthcare use were assessed by blinded interviewer-administered questionnaires in Sylheti before randomisation and 4 months later.Results Of the 1363 people invited, 476 (34%) agreed to take part and 92% (439/476) of participants were followed up. The programme improved self-efficacy (difference: 0.67, 95% confidence interval [CI] = 0.08 to 1.25) and self-management behaviour (0.53; 95% CI = 0.01 to 1.06). In the 51% (121/238) of intervention participants attending three or more of the 6-weekly education sessions the programme led to greater improvements in self-efficacy (1.47; 95% CI = 0.50 to 1.82) and self-management behaviour (1.16; 95% CI = 0.50 to 1.82), and reduced HADS depression scores (0.64; 95% CI = 0.07 to 1.22). Communication and healthcare use were not significantly different between groups. The programme cost £123 (€181) per participant.Conclusion A culturally-adapted CDSMP improves self-efficacy and self-care behaviour in Bangladeshi patients with chronic disease. Effects on health status were marginal. Benefits were limited by moderate uptake and attendance.