The association between patient activation and medication adherence, hospitalization, and emergency room utilization in patients with chronic illnesses: A systematic review

Kinney, Rebecca L.; Lemon, Stephenie C.; Person, Sharina D.; Pagoto, Sherry L.; Saczynski, Jane S.

doi:10.1016/j.pec.2015.02.005

Cited by 122 publications

(117 citation statements)

References 49 publications

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“…14,26 The inverse, though nonsignificant, association between past hospitalizations and patient activation is in line with previous findings of an association between low PAM scores and a higher number of hospitalizations. 11 …”

Section: Discussionmentioning

confidence: 99%

“…4,5 Findings from recent studies suggest that patients with a higher activation are more likely to adhere to medical regimens and effectively manage chronic medical conditions, and less likely to be hospitalized. 11–13 Limited prior studies of patient activation in older adults (individuals age 65 and older) indicate that higher PAM activation scores are associated with higher functional status, health care quality, and adherence in older adults. 14 The few studies that examined PAM in older adults have focused on individuals with specific chronic diseases but not necessarily functional difficulties.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with patient activation in an older adult population with functional difficulties

Gleason

Tanner

Boyd

et al. 2016

Patient Education and Counseling

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Objective Patient activation, the patient’s knowledge, skill, and confidence to manage his or her health, is an important indicator of future health and use of health care resources. Understanding factors associated with patient activation in an older population with functional difficulties may inform care in this population. This study aimed to determine whether patient activation is associated with depression, chronic conditions, family support, difficulties with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), hospitalizations, education, and financial strain. Methods (N=277), We administered surveys measuring patient activation, financial strain, depressive symptoms, family support, and chronic conditions to an older adult population. We tested association through multivariate linear regressions controlling for race, sex, and age. Results Patient activation is significantly (p<0.05), positively associated with family support and self-rated overall health, and significantly (p<0.05), negatively associated with depressive symptoms and difficulties with ADLs and IADLs. We found no association between patient activation and financial stress, hospitalizations, and education. Conclusions Older age, depressive symptoms, and difficulties with ADLs and IADLs were associated with decreased patient activation. Practice Implications Developing interventions tailored to older adults’ level of patient activation has the potential to improve outcomes for this population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors associated with patient activation in an older adult population with functional difficulties

Gleason

Tanner

Boyd

et al. 2016

Patient Education and Counseling

Self Cite

View full text Add to dashboard Cite

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“…Content validity of the PAM was evaluated by calculating the content validity index (CVI) and the content validity ratio (CVR) as recommended by Lynn (1986). A panel of 10 experts from the hospital setting was asked to rate each item on the PAM for its relevance to the underlying constructs of the PAM.…”

Section: Content Validitymentioning

confidence: 99%

Psychometric Properties of the Patient Activation Measure in Multimorbid Hospitalized Patients

Schmaderer¹,

Pozehl²,

Hertzog

et al. 2015

j nurs meas

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“…Moreover, activated patients are more likely to have clinical outcomes, such as HbA1c concentration and body mass index in the normal range [51]. Critically, highly activated patients are more satisfied with their care experience and have lower rates of hospital admissions and emergency room use, possibly leading to reductions in the cost of their care [52, 53]. …”

Section: Methodsmentioning

confidence: 99%

Comparison of active treatments for impaired glucose regulation: a Salford Royal Foundation Trust and Hitachi collaboration (CATFISH): study protocol for a randomized controlled trial

Coventry

Bower

Blakemore

et al. 2016

Trials

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BackgroundDiabetes is highly prevalent and contributes to significant morbidity and mortality worldwide. Behaviour change interventions that target health and lifestyle factors associated with the onset of diabetes can delay progression to diabetes, but many approaches rely on intensive one-to-one contact by specialists. Health coaching is an approach based on motivational interviewing that can potentially deliver behaviour change interventions by non-specialists at a larger scale. This trial protocol describes a randomized controlled trial (CATFISH) that tests whether a web-enhanced telephone health coaching intervention (IGR3) is more acceptable and efficient than a telephone-only health coaching intervention (IGR2) for people with prediabetes (impaired glucose regulation).MethodsCATFISH is a two-parallel group, single-centre individually randomized controlled trial. Eligible participants are patients aged ≥18 years with impaired glucose regulation (HbA1c concentration between 42 and 47 mmol/mol), have access to a telephone and home internet and have been referred to an existing telephone health coaching service at Salford Royal NHS Foundation Trust, Salford, UK. Participants who give written informed consent will be randomized remotely (via a clinical trials unit) to either the existing pathway (IGR2) or the new web-enhanced pathway (IGR3) for 9 months. The primary outcome measure is patient acceptability at 9 months, determined using the Client Satisfaction Questionnaire. Secondary outcome measures at 9 months are: cost of delivery of IGR2 and IGR3, mental health, quality of life, patient activation, self-management, weight (kg), HbA1c concentration, and body mass index. All outcome measures will be analyzed on an intention-to-treat basis. A qualitative process evaluation will explore the experiences of participants and providers with a focus on understanding usability of interventions, mechanisms of behaviour change, and impact of context on delivery and user acceptability. Qualitative data will be analyzed using Framework.DiscussionThe CATFISH trial will provide a pragmatic assessment of whether a web-based information technology platform can enhance acceptability of a telephone health coaching intervention for people with prediabetes. The data will prove critical in understanding the role of web applications to improve engagement with evidence-based approaches to preventing diabetes.Trial registrationISRCTN16534814. Registered on 7 February 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1519-6) contains supplementary material, which is available to authorized users.

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The association between patient activation and medication adherence, hospitalization, and emergency room utilization in patients with chronic illnesses: A systematic review

Cited by 122 publications

References 49 publications

Factors associated with patient activation in an older adult population with functional difficulties

Factors associated with patient activation in an older adult population with functional difficulties

Psychometric Properties of the Patient Activation Measure in Multimorbid Hospitalized Patients

Comparison of active treatments for impaired glucose regulation: a Salford Royal Foundation Trust and Hitachi collaboration (CATFISH): study protocol for a randomized controlled trial

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