Furthermore, their

improvement was greater at 6 months follow-up. Condition was also apredictor of changes in depression over time (p < 0.001). Patients with depression and patients with pain had higher levels of anxiety at baseline compared to patients with COPD and patients with diabetes and their improvement was greater at 6 months follow-up. RAD001 ITT analysis produced similar results. At baseline 39.8% of patients were clinically anxious (caseness (≥11)) and at 6 months follow-up this had significantly reduced to 29.7% (p < 0.001). Compared with baseline, 17% moved from clinical to non-clinical anxiety, 7% moved from non-clinical to clinical and 76% stayed the same. At baseline 25.6% of patients were clinically depressed

(caseness (≥11)) and at 6 months follow-up this had significantly reduced to 16.0% (p < 0.001). Compared with baseline, 15% moved from clinical to non-clinical depression, 6% moved from non-clinical to clinical and 79% stayed the same. Patients’ self-management skills in all eight heiQ domains significantly improved 6 months after attending the SMP: Health Directed Behavior: (p = 0.028); Positive and Active Engagement; Emotional check details Well-Being; Self-Monitoring and Insight; Constructive Attitude Shift; Skills and Technique Acquisition (all p < 0.001); Social Integration and support; p = 0.002, and Health Service Navigation (p = 0.012). Effect sizes ranged from 0.67 for Skills and Technique Acquisition to 0.17 for Health Service Navigation ( Table 2). Condition was a predictor of change in three of the domains: patients

with depression reported a statistically significant improvement over time on Positive and Active Engagement, Constructive Attitude Shift (both p < 0.001) and Social Integration and Support (p < 0.002). Patients with diabetes also reported an improvement in this domain (p = 0.03). ITT analysis produced Edoxaban similar results. About a quarter of patients showed substantial improvements in self-management skills, the exceptions being skill and technique acquisition (35.4%) improvement and health service navigation (18.3%) ( Table 4). The WHO has called upon all countries to provide interventions, including self-care interventions, to address the worldwide LTC epidemic [29]. This study, which describes an evaluation of a group-based SMP carried out in a real world health care setting showed that, it has the potential to improve patient activation, quality of life, psychological distress and self-management skills. We do not know the total number of LTC patients who were approached by health care staff at each site to register with the SMP recruitment helpline. We do know that 30% of patients who contacted the recruitment helpline did not subsequently attend the SMP.