Principles of self-control and self-help education for patients with chronic non-communicable diseases (literature review)

The article provides an overview of domestic and foreign reports on the possibility of implementing self-monitoring and self-control training programs for people suffering from chronic non-communicable diseases (CNCD). There were analyzed at least 1,500 domestic and foreign reports on a given topic, which are available in the databases Scopus, Web of Science, MedLine, The Cochrane Library, CyberLeninka, RSCI and on the WHO website. Data are presented on the possibility of using various patient education options, in particular, such as “patient schools” with CNCD, their effectiveness in terms of improving compliance and the pharmacoeconomic effectiveness of treatment. The difficulties experienced by patients in studying special information related to the disease and determining the search for new solutions in this area are outlined. The relevance of including the teach-back method in working with patients, which is used in various fields of healthcare and allow not only to providing the patient with the most detailed information, but also receiving feedback from him indicating the level of her understanding (based on clarifying questions from the specialist and the patient’s answers, reflecting a sufficient understanding of the essence of the information provided). There are given examples of works demonstrated the relevance of introducing feedback learning when it is included in medical education programs for adult CNCD patients. The reasonable inclusion of systematic educational programs with feedback in the monitoring scheme for this category of patients was shown to make it possible to optimize the treatment process, reduce the labor costs of medical personnel, significantly reduce the time spent by patients in outpatient and inpatient treatment facilities, and reduce the risk of repeated hospitalization.

Contribution of the authors:
Kukshina A.A. — research concept and design, literature analysis, text writing, bibliography, editing;
Kamynina N.N. — research concept and design, text writing, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Funding. This article was prepared by the author’s team within the framework of the research «Innovative approaches in the development of the public health system of the city of Moscow» (no. according to EGISU: № 123032100060-2).

Conflict of interest. The authors declare no conflict of interest.

Received: March 28, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

1. Murray C.J.L. The global burden of disease study at 30 years. Nat. Med. 2022; 28(10): 2019–26. https://doi.org/10.1038/s41591-022-01990-1

2. Yu Y., Sun Y., Yu Y., Wang Y., Chen C., Tan X., et al. Life’s Essential 8 and risk of non-communicable chronic diseases: outcome-wide analyses. Chin. Med. J. (Engl.). 2024; 137(13): 1553–62. https://doi.org/10.1097/CM9.0000000000002830

3. Stein S. Genetics loads the gun; lifestyle pulls the trigger. J. Nutr. Health Food Eng. 2015; 3: 316–7.

4. GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024; 403(10440): 2133–61. https://doi.org/10.1016/S0140-6736(24)00757-8

5. Doyle J., Murphy E., Gavin S., Pascale A., Deparis S., Tommasi P., et al. A digital platform to support self-management of multiple chronic conditions (ProACT): findings in relation to engagement during a one-year proof-of-concept trial. J. Med. Internet Res. 2021; 23(12): e22672. https://doi.org/ 10.2196/22672

6. Lloyd-Jones D.M., Allen N.B., Anderson C.A.M., Black T., Brewer L.C., Foraker R.E., et al. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation. 2022; 146(5): e18–e43. https://doi.org/10.1161/CIR.0000000000001078

7. Barlow J., Wright C., Sheasby J., Turner A., Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Educ. Couns. 2002; 48(2): 177–87. https://doi.org/10.1016/s0738-3991(02)00032-0

8. Liddy C., Blazkho V., Mill K. Challenges of self-management when living with multiple chronic conditions: systematic review of the qualitative literature. Can. Fam. Physician. 2014; 60(12): 1123–33.

9. Morton K., Dennison L., May C., Murray E., Little P., McManus R.J., et al. Using digital interventions for self-management of chronic physical health conditions: A meta-ethnography review of published studies. Patient Educ. Couns. 2017; 100(4): 616–35. https://doi.org/10.1016/j.pec.2016.10.019

10. Johnston S., Liddy C., Mill K., Irving H. Building the evidence base for chronic disease self-management support interventions across Canada. Can. J. Public Health. 2012; 103(6): e462–7. https://doi.org/10.1007/BF03405639

11. Lorig K.R., Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann. Behav. Med. 2003; 26(1): 1–7. https://doi.org/10.1207/S15324796ABM2601_01

12. Kumar A.B., Kosherbayeva L., Kurakbayev K.K., Meymanaliyev T.S., Abuov D.Z.H. Training of patients as a method of quality improvement of primary medical care. Meditsinskii zhurnal Zapadnogo Kazakhstana. 2014; (3): 73–5. https://elibrary.ru/uiqekv (in Russian)

13. WHO. Therapeutic patient education: introductory guidance. Copenhagen; 2023. Available at: https://who.int/europe/ru/publications/i/item/9789289060219 (in Russian)

14. Kardas P. Prevalence of non-adherence to medication among patients treated for selected chronic conditions. Pol. Merkur. Lekarski. 2011; 31(184): 215–20.

15. Danilov A.B., Shevchenko E.V. Impact of patient information-educational preparation on clinical, financial, and economic factors and treatment satisfaction. Nevrologiya, neiropsikhiatriya, psikhosomatika. 2014; (2): 29–33. https://elibrary.ru/siuphl (in Russian)

16. Volkova A.R., Lisker G.V., Semikova G.V., Mozgunova V.S. Insulin therapy in patients with type 2 diabetes mellitus: a focus on therapeutic education. Endokrinologiya: novosti, mneniya, obuchenie. 2021; 3(10): 16–21. https://doi.org/10.33029/2304-9529-2021-10-3-16-21 https://elibrary.ru/fcexrt (in Russian)

17. Isakova D.N., Dorodneva E.F., Belokrylova L.V., Kurmangulov A.A., Petrov I.M. The role of nutritional factors in the formation of cardiovascular risk in patients with type 2 diabetes mellitus. Voprosy pitaniya. 2021; 90(5): 104–14. https://doi.org/10.33029/0042-8833-2021-90-5-104-114 https://elibrary.ru/fstoeh (in Russian)

18. Nogaeva M.G., Vinnikov D.V., Brimkulov N.N. Impact of self-control skill teaching on the efficiency of treatment in patients with rheumatoid arthritis. Nauchno-prakticheskaya revmatologiya. 2018; 56(5): 581–5. https://elibrary.ru/yobtrb (in Russian)

19. Orlova E.V., Denisov L.N., Arsenyev A.O., Karateev D.E. Assessment of adherence to drug and non-drug treatments and its changes under the influence of an education program in patients with rheumatoid arthritis. Nauchno-prakticheskaya revmatologiya. 2012; 50(3): 68–74. https://elibrary.ru/plwymz (in Russian)

20. Rozhnev V.V., Gorbunova E.V., Lyapina I.N., Barbarash O.L. Modern approaches to patient education after heart valve replacement. Rossiiskii kardiologicheskii zhurnal. 2023; 28(S7): 47. https://elibrary.ru/uozvfe (in Russian)

21. Borovkova N.Yu., Borovkov N.N., Maslova T.I., Borovkova E.I., Khorkina Yu.A. The influence of patient education on treatment adherence in renoparenchymal arterial hypertension. Arkhiv” vnutrennei meditsiny. 2013; (6): 65–9. https://elibrary.ru/rvlixj (in Russian)

22. Sobchenko S.A., Evtyushkina S.N., Kharitonov M.A., Kazantsev V.A., Butko D.Yu., Cherkashin D.V., et al. Strategy of adherence to long-term bronchial asthma control formation. Klinicheskaya meditsina. 2020; 98(11–12): 772–80. https://doi.org/10.30629/0023-2149-2020-98-11-12-772-780 https://elibrary.ru/gifrlb (in Russian)

23. Ishmurzin G.P. The effect of training of COPD patients and bronchial asthma on the frequency of exacerbations requiring emergency hospitalization. Vestnik sovremennoi klinicheskoi meditsiny. 2015; 8(Suppl. 1): 46–56. (in Russian)

24. Khokhlacheva N.A., Mikhaylova O.D., Bystrova A.V. Education of patients with stage I cholelithiasis at the health school. Arkhiv vnutrennei meditsiny. 2019; 9(3): 201–5. https://doi.org/10.20514/2226-6704-2019-9-3-201-205 https://elibrary.ru/naorye (in Russian)

25. Sui M., Cheng M., Zhang S., Wang Y., Yan Q., Yang Q., et al. The digitized chronic disease management model: scalable strategies for implementing standardized healthcare and big data analytics in Shanghai. Front. Big Data. 2023; 6: 1241296. https://doi.org/10.3389/fdata.2023.1241296

26. Brunton S.A. Improving medication adherence in chronic disease management. J. Fam. Pract. 2011; 60(4 Suppl.): S1-8.

27. Kessels R.P. Patients’ memory for medical information. J. R. Soc. Med. 2003; 96(5): 219–22. https://doi.org/10.1177/014107680309600504

28. Yen P.H., Leasure A.R. Use and effectiveness of the teach-back method in patient education and health outcomes. Fed. Pract. 2019; 36(6): 284–9.

29. Jager A.J., Wynia M.K. Who gets a teach-back? Patient-reported incidence of experiencing a teach-back. J. Health Commun. 2012; 17 (Suppl. 3): 294–302. https://doi.org/10.1080/10810730.2012.712624

30. Ha Dinh T.T., Bonner A., Clark R., Ramsbotham J., Hines S. The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: a systematic review. JBI Database System Rev. Implement. Rep. 2016; 14(1): 210–47. https://doi.org/10.11124/jbisrir-2016-2296

31. Farahaninia M., Hoseinabadi T.S., Raznahan R., Haghani S. The teach-back effect on self-efficacy in patients with type 2 diabetes. Rev. Diabet Stud. 2020; 16(1): 46–50. https://doi.org/10.1900/RDS.2020.16.46

32. Ahmadidarrehsima S., Bidmeshki E.A., Rahnama M., Babaei K., Afshari M., Khandani B.K. The effect of self-management education by the teach-back method on uncertainty of patients with breast cancer: a quasi-experimental study. J. Cancer Educ. 2020; 35(2): 366–72. https://doi.org/10.1007/s13187-019-1474-5

33. Charais C., Bowers M., Do O.O., Smallheer B. Implementation of a disease management program in adult patients with heart failure. Prof. Case Manag. 2020; 25(6): 312–23. https://doi.org/10.1097/NCM.0000000000000413

34. Mashhadi S.F., Hisam A., Sikander S., Rathore M.A., Rifaq F., Khan S.A., et al. Post discharge mHealth and teach-back communication effectiveness on hospital readmissions: a systematic review. Int. J. Environ. Res. Public Health. 2021; 18(19): 10442. https://doi.org/10.3390/ijerph181910442

35. Oh E.G., Lee H.J., Yang Y.L., Kim Y.M. Effectiveness of discharge education with the teach-back method on 30-day readmission: a systematic review. J. Patient Saf. 2021; 17(4): 305–10. https://doi.org/10.1097/PTS.0000000000000596

36. Mohammadi F., Jahromi M.S., Bijani M., Karimi S., Dehghan A. Investigating the effect of multimedia education in combination with teach-back method on quality of life and cardiac anxiety in patients with heart failure: a randomized clinical trial. BMC Cardiovasc. Disord. 2021; 21(1): 535. https://doi.org/10.1186/s12872-021-02357-z

37. Najafi E., Rafiei H., Rashvand F., Pazoki A. The effects of teach-back and blended training on self-care and care burden among caregivers of patients with heart failure caregivers. Home Healthc. Now. 2024; 42(6): 354–63. https://doi.org/10.1097/NHH.0000000000001305

38. Xia F., Wang G. Influence of teach-back strategy on hemodialysis related knowledge level, self-efficacy and self-management in patients receiving maintenance hemodialysis. Sci. Rep. 2024; 14(1): 4010. https://doi.org/10.1038/s41598-024-54044-6

39. Manzari Z.S., Vossoughinia H., Nedaei B., Rafiei H., Mafi M.H. Self-efficacy in patients with inflammatory bowel disease: the effect of self-care education by two randomized methods-teach-back and a smartphone application. Health Educ. Res. 2024; 39(6): 535–43. https://doi.org/10.1093/her/cyae033

40. Jagodage M.H.H., McGuire A., Seib C., Bonner A. Effectiveness of teach-back for chronic kidney disease patient education: a systematic review. J. Ren. Care. 2024; 50(2): 92–103. https://doi.org/10.1111/jorc.12462

41. Zare-Kaseb A., Emami Zeydi A., Bakhtiari-Dovvombaygi H., Nazari A.M. Effects of education based on teach-back methods on self‑care and quality of life of the patients with heart failure: a systematic review. BMC Cardiovasc. Disord. 2024; 24(1): 591. https://doi.org/10.1186/s12872-024-04264-5

42. Holman C.K., Weed L.D., Kelley S.P. Improving provider use of the teach-back method. J. Nurses Prof. Dev. 2019; 35(1): 52–3. https://doi.org/10.1097/NND.0000000000000521

43. Goeman D., Conway S., Norman R., Morley J., Weerasuriya R., Osborne R.H., et al. Optimising health literacy and access of service provision to community dwelling older people with diabetes receiving home nursing support. J. Diabetes Res. 2016; 2016: 2483263. https://doi.org/10.1155/2016/2483263

44. Hong Y.R. Cardel M., Suk R., Vaughn I.A., Deshmukh A.A., Fisher C.L., et al. Teach-back experience and hospitalization risk among patients with ambulatory care sensitive conditions: a matched cohort study. J. Gen. Intern. Med. 2019; 34: 2176–84. https://doi.org/10.1007/s11606-019-05135

45. Cabilan C.J., Boyde M., Currey E. The effectiveness of pharmacist- led discharge medication counselling in the emergency department (ExPLAIN): a pilot quasi-experimental study. Patient Educ. Couns. 2019; 102: 1157–63. https://doi.org/10.1016/j.pec.2019.01.020

46. Mollazadeh F., Hemmati Maslakpak M. The effect of teach-back training on self management in kidney transplant recipients: a clinical trial. Int. J. Community Based Nurs. Midwifery. 2018; 6(2): 146–55.