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OBJECTIVE: Investigate the effects of disease management program (DMP) implementation on physical activity, smoking, and physical quality of life among chronically ill patients. METHODS: This study used a mixed-methods approach involving qualitative (35 interviews with project managers) and quantitative (survey of patients from 18 DMPs) data collection. Questionnaire response rates were 51% (2010; 2619/5108) at T0 and 47% (2011; 2191/4693) at T1. RESULTS: Physical activity and the percentage of smokers improved significantly over time, whereas physical quality of life declined. After adjusting for patients' physical quality of life at T0, age, educational level, marital status, and gender, physical activity at T0 (p<0.01), changes in physical activity (p<0.001), and percentage of smokers at T0 (p<0.05) predicted physical quality of life at T1. Project managers reported that DMPs improved patient-professional interaction. The ability to set more concrete targets improved patients' health behaviors. CONCLUSIONS: DMPs appear to improve physical activity among chronically ill patients over time. Furthermore, (changes in) health behavior are important for the physical quality of life of chronically ill patients. PRACTICE IMPLICATIONS: Redesigning care systems and implementing DMPs based on the chronic care model may improve health behavior among chronically ill patients.

Original publication




Journal article


Patient Educ Couns

Publication Date





137 - 142


Chronic care, Disease management, Health behavior, Integrated care, Quality of life, Adult, Aged, Aged, 80 and over, Chronic Disease, Disease Management, Female, Health Behavior, Humans, Interviews as Topic, Male, Middle Aged, Motor Activity, National Health Programs, Outcome and Process Assessment, Health Care, Program Evaluation, Qualitative Research, Quality of Life, Smoking, Socioeconomic Factors, Surveys and Questionnaires