Patients listed at a primary care centre in Närhälsan with CHF and/or COPD will be randomized to usual care (control) or gPCC (intervention) after informed and written consent. Follow-up questionnaires on general self-efficacy, cardiac self-efficacy, quality of life, anxiety and depression will be sent out to all patients in both groups after 3,6,12 and 24 months after randomization.