Journal ArticleDOI
Effect of patient activation on self-management in patients with heart failure
Martha Shively,Nancy Gardetto,Mary F. Kodiath,Ann Kelly,Tom L. Smith,Carl Stepnowsky,Charles Maynard,Carolyn B. Larson +7 more
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TLDR
The intervention group compared with the usual care group showed a significant increase in activation/PAM scores from baseline to 6 months, and a significant group-by-time effect with the intervention group improving more over time.Abstract:
BACKGROUND/OBJECTIVE: Few studies have examined whether chronic heart failure (HF) outcomes can be improved by increasing patient engagement (known as activation) in care and capabilities for self-care management. The objective was to determine the efficacy of a patient activation intervention compared with usual care on activation, self-care management, hospitalizations, and emergency department visits in patients with HF. METHODS: This study used a randomized, 2-group, repeated-measures design. After consent was given, 84 participants were stratified by activation level and randomly assigned to usual care (n = 41) or usual care plus the intervention (n = 43). The primary outcomes and measures were patient activation using the Patient Activation Measure (PAM), self-management using the Self-Care of Heart Failure Index (SCHFI) and the Medical Outcomes Study (MOS) Specific Adherence Scale, and hospitalizations and emergency department visits. The intervention was a 6-month program to increase activation and improve HF self-management behaviors, such as adhering to medications and implementing health behavior goals. RESULTS: Participants were primarily male (99%), were white (77%), and had New York Heart Association III stage (52%). The mean (SD) age was 66 (11) years, and 71% reported 3 or more comorbidities. The intervention group compared with the usual care group showed a significant increase in activation/PAM scores from baseline to 6 months. No significant group-by-time interactions were found for the SCHFI scales. Although the baseline MOS Specific Adherence Scale mean was lower in the intervention group, results showed a significant group-by-time effect with the intervention group improving more over time. Participants in the intervention group had fewer hospitalizations compared with the usual care group when the baseline activation/PAM level was low or high. CONCLUSION: This study supports the importance of targeted interventions to improve patient activation or engagement in HF care. Further work is needed related to HF self-management measurement and outcomes.read more
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Journal ArticleDOI
What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs
Judith H. Hibbard,Jessica Greene +1 more
TL;DR: It is concluded that policies and interventions aimed at strengthening patients' role in managing their health care can contribute to improved outcomes and that patient activation can-and should-be measured as an intermediate outcome of care that is linked toImproved outcomes.
Journal ArticleDOI
Psychological interventions for coronary heart disease
Suzanne H Richards,Lindsey Anderson,Caroline E Jenkinson,Ben Whalley,Karen Rees,Philippa Davies,Paul Bennett,Z Liu,Robert West,David R. Thompson,Rod S Taylor +10 more
TL;DR: To assess the effectiveness of psychological interventions compared with usual care for people with CHD on total mortality and cardiac mortality; cardiac morbidity; and participant-reported psychological outcomes of levels of depression, anxiety, and stress, a Cochrane systematic review is published.
Journal ArticleDOI
Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients’ ‘Scores’
TL;DR: In an analysis of 33,163 patients of Fairview Health Services, a large health care delivery system in Minnesota, it was found that patients with the lowest activation levels had predicted average costs that were 8 percent higher in the base year and 21 percentHigher in the first half of the next year than the costs of Patients with the highest activation levels, both significant differences.
Journal ArticleDOI
Medication Adherence Interventions Improve Heart Failure Mortality and Readmission Rates: Systematic Review and Meta-Analysis of Controlled Trials.
TL;DR: Medication adherence should be addressed in regular follow‐up visits with HF patients, and interventions to improve adhere should be a key part of HF self‐care programs.
Journal ArticleDOI
Remote Monitoring of Patients With Heart Failure: An Overview of Systematic Reviews
Nazli Bashi,Mohanraj Karunanithi,Farhad Fatehi,Farhad Fatehi,Farhad Fatehi,Hang Ding,Darren L. Walters +6 more
TL;DR: In this paper, the authors investigated the effects of remote patient monitoring interventions on the health outcomes of patients with heart failure by synthesizing review-level evidence and concluded that telemonitoring and home telehealth appear generally effective in reducing heart failure rehospitalization and mortality.
References
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Missing data: Our view of the state of the art.
Joseph L. Schafer,John W. Graham +1 more
TL;DR: 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI) are presented and may eventually extend the ML and MI methods that currently represent the state of the art.
Journal ArticleDOI
Development of the Patient Activation Measure (PAM): Conceptualizing and Measuring Activation in Patients and Consumers
TL;DR: The Patient Activation Measure is a valid, highly reliable, unidimensional, probabilistic Guttman-like scale that reflects a developmental model of activation that has good psychometric properties indicating that it can be used at the individual patient level to tailor intervention and assess changes.
Chronic disease management: what will it take to improve care for chronic illness?
TL;DR: Results of randomized trials show that effective disease management programs can achieve substantially better outcomes than usual care, the control intervention, and the evidence strongly suggests that ambulatory care systems should be reshaped for this purpose.
Journal ArticleDOI
Development and testing of a short form of the patient activation measure.
TL;DR: The results of the analysis indicate that the shortened 13-item version of the Patient Activation Measure is both reliable and valid.
Journal ArticleDOI
Development of a brief test to measure functional health literacy.
TL;DR: The development of an abbreviated version of the Test of Functional Health Literacy in Adults (TOFHLA) to measure patients' ability to read and understand health-related materials that can be used by health educators to identify individuals who require special assistance to achieve learning goals is described.
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