Is Patient Activation Associated With Outcomes of Care for Adults With Chronic Conditions?

Mosen, David M.; Schmittdiel, Julie A.; Hibbard, Judith H.; Sobel, David S.; Remmers, Carol; Bellows, Jim

doi:10.1097/00004479-200701000-00005

Cited by 430 publications

(376 citation statements)

References 11 publications

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“…eye examinations for people with diabetes, keeping diary of blood pressure readings), and control of chronic illness (e.g. HbA1c control, fewer hospitalizations) 13,14,[16][17][18][19][20] . Many of the studies are limited, however, by reliance upon self-reported health outcomes and use of relatively small samples.…”

Section: Introductionmentioning

confidence: 99%

Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes

2011

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BACKGROUND: There is a growing awareness that patients should be more active and effective managers of their health and health care. Recent studies have found patient activation-or having the knowledge, skills, and confidence to manage one's health, to be related to health-related outcomes. These studies have often relied on self-reported outcomes and often have used small samples. OBJECTIVE: To examine the degree to which patient activation is related to a broad range of patient health and utilization outcomes in a large, insured population. DESIGN: Cross-sectional study of patients at Fairview Health Services in Minnesota. Data on patient activation and patient outcomes were derived from the electronic health record, abstracted in December 2010. PATIENTS: A total of 25,047 adult patients were included in the analysis. They all had a primary care visit in the prior six months and completed the patient activation measure as part of an office visit. MAIN MEASURES: The key independent measure was the Patient Activation Measure. We examined 13 patient outcomes across four areas: prevention, unhealthy behaviors, clinical indicators, and costly utilization. RESULTS: In multivariate models, patient activation was related to 12 of 13 patient outcomes in the expected direction. For every additional 10 points in patient activation, the predicted probability of having an ED visit, being obese, or smoking was one percentage point lower. The likelihood of having a breast cancer screen or clinical indicators in the normal range (A1c, HDL, and triglycerides) was one percentage point higher. CONCLUSIONS: This cross sectional study finds that patient activation is strongly related to a broad range of health-related outcomes, which suggests improving activation has great potential. Future work should examine the effectiveness of interventions to support patient activation.KEY WORDS: patient activation; patient engagement; health care quality.

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Section: Introductionmentioning

confidence: 99%

Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes

2011

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“…Patient Activation is linked to health outcomes. 6 Physician skills such as participatory decision making can lead to improved patient activation and better outcomes. 7 Hibbard's Patient Activation Measure (PAM) has been shown to be a reliable measure, relatively easy to administer, and has been proposed as a health care quality measure.…”

Section: Introductionmentioning

confidence: 99%

Health Literacy: An Educationally Sensitive Patient Outcome

et al. 2015

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We have previously proposed that by identifying a set of Educationally Sensitive Patient Outcomes (ESPOs), medical education outcomes research becomes more feasible and likely to provide meaningful guidance for medical education policy and practice. ESPOs are proximal outcomes that are sensitive to provider education, measurable, and linked to more distal health outcomes. Our previous model included Patient Activation and Clinical Microsystem Activation as ESPOs. In this paper, we discuss how Health Literacy, defined as Bthe degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions,^is another important ESPO. Between one-third and one-half of all US adults have limited health literacy skills. Providers can be trained to adopt a Buniversal precautions approach^to addressing patient health literacy, through the acquisition of specific skills (e.g., teachback, Bchunking^infor-mation, use of plain language written materials) and by learning how to take action to improve the Bhealth literacy environment.^While there are several ways to measure health literacy, identifying which measurement tools are most sensitive to provider education is important, but challenging and complex. Further research is needed to test this model and identify additional ESPOs.

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“…Conversely, one may emphasize patient activation given links to greater self-management of mental illness in people with medical conditions (Mosen et al, 2006;Hibbard et al, 2007) as well as mental health conditions (Salyers et al, 2009;Green et al, 2010;Kukla et al, 2013). For example, Alexander et al (2012) noted that as little as establishing patient-physician relationships might help foster patient activation.…”

Section: Discussionmentioning

confidence: 99%

“…In a study of consumers with chronic conditions, including diabetes, asthma, heart failure, coronary artery disease, and chronic pain, Mosen et al (2006) found that higher patient activation was associated with better medication adherence, more involvement in selfmanagement services, and better quality of life and physical and mental functioning. Hibbard et al (2007) studied similar populations and found that the amount of self-management behaviors increased in consumers with high activation, and the change in behaviors lasted over time.…”

Section: Patient Activationmentioning

confidence: 99%

The relationship between hope and patient activation in consumers with schizophrenia: Results from longitudinal analyses

Oles

Fukui

Rand

et al. 2015

Psychiatry Research

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Is Patient Activation Associated With Outcomes of Care for Adults With Chronic Conditions?

Cited by 430 publications

References 11 publications

Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes

Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes

Health Literacy: An Educationally Sensitive Patient Outcome

The relationship between hope and patient activation in consumers with schizophrenia: Results from longitudinal analyses

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