To the editor In the Netherlands, the combination of an aging population and increasing cut-backs in health care will result in a growing burden on the health care system [1]. Studies on self-management programmes, however, have demonstrated a significant reduction in health care utilization among participants in such programmes [2–14]. The Chronic Disease Self-Management Program (CDSMP) of Lorig et al . is such a self-management programme [4,7,8]. Although studies showed that participating in this programme can reduce health care utilization, this programme has not yet been evaluated in the Netherlands. Therefore, we evaluated the effect of the CDSMP on health care utilization among chronically ill older people in the Netherlands. Based on...