Is Patient Activation Associated With Future Health Outcomes and Healthcare Utilization Among Patients With Diabetes?
Abstract
We examined the relationship between the patient activation measure (PAM) and future diabetes-related health outcomes through retrospective analysis of secondary data using multivariate logistic regression. PAM scores from a 2004 survey on 1180 randomly sampled adults with diabetes and health information from a 2006 diabetes registry were the data sources used. The PAM was predictive for hemoglobin A1c (HgA1c) testing (P < .008), low-density lipoprotein cholesterol (LDL-C) testing (P < .005), HgA1c control (P < .01), and all-cause discharges (P < .03), but not for lipid-lowering drug use, LDL-C control, or acute myocardial infarction discharges. These results suggest that PAM scores can be used to identify patients at risk for poorer health outcomes.
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Poor medication adherence, lack of patient engagement, and therapeutic inertia are major contributors to patients not reaching their therapeutic targets.
“Poor medication adherence, lack of patient engagement, and therapeutic inertia are major contributors to patients not reaching their therapeutic targets [8-12].”
The Patient Activation Measure (PAM) is a validated measure of patient activation that includes a person's beliefs, motivation, and actions for self-care.
“Participants also completed the 10-question Patient Activation Measure (PAM), a validated measure of patient activation that includes person’s beliefs, motivation, and actions for self-care at these visits [9,23,24].”
A 1-point increase in PAM score is associated with a 1.8% increased likelihood of decreasing HbA1c to less than 8%.
“a 1-point increase in PAM score is associated with a 1.8% increased likelihood of decreasing HbA1c to less than 8% [9].”
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Weisner, C. M., Chi, F. W., Lu, Y., Ross, T. B., Wood, S. B., Hinman, A., Pating, D., Satre, D. D., & Sterling, S. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.0970 · Cited by 30 · see citing works
The pharmacy care plan service: Evaluation and estimate of cost-effectiveness
Twigg, M. J., Wright, D. J., Barton, G., Kirkdale, C. L., & Thornley, T. (2018) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2018.03.062 · Cited by 31 · see citing works
Rijken, M., Heijmans, M., Jansen, D. L., & Rademakers, J. J. D. J. M. (2014) · Patient Education and Counseling · doi:10.1016/j.pec.2014.09.006 · Cited by 30 · see citing works
Rosland, A.-M. M., Piette, J. D., TRIVEDI, R. B., Kerr, E. A., STOLL, S. C., Tremblay, A. S., & Heisler, M. (2018) · Trials · doi:10.1186/s13063-018-2785-2 · Cited by 29 · see citing works
Menichetti, J., & Graffigna, G. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01405 · Cited by 27 · see citing works
Lee, M.-K., Lee, D. Y., Ahn, H.-Y., & Park, C.-Y. (2021) · JMIR mHealth and uHealth · doi:10.2196/17573 · Cited by 27 · see citing works
Interaction between functional health literacy, patient activation, and glycemic control
Woodard, L., Landrum, C. R., Amspoker, A. B., Ramsey, D. J., & Naik, A. D. (2014) · Patient Preference and Adherence · doi:10.2147/ppa.s63954 · Cited by 27 · see citing works
Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes
Michaud, T. L., Siahpush, M., Schwab, R. J., Eiland, L. A., DeVany, M., Hansen, G., Slachetka, T. S., Boilesen, E. C., Tak, H. J., Wilson, F. A., et al. (2018) · Population Health Management · doi:10.1089/pop.2017.0175 · Cited by 27 · see citing works
Mayberry, R., Willock, R. J., Boone, L. R., Lopez, P., Qin, H., & Nicewander, D. A. (2010) · Diabetes Spectrum · doi:10.2337/diaspect.23.3.171 · Cited by 27 · see citing works
Ryvicker, M. B., Feldman, P. H., Chiu, Y., & Gerber, L. M. (2013) · Medical Care Research and Review · doi:10.1177/1077558713495452 · Cited by 26 · see citing works
Feedback to Patients About Patient-reported Outcomes Does Not Improve Empowerment or Satisfaction
Ackermans, L., Hageman, M., Bos, A. H., Haverkamp, D., Scholtes, V. A., & Poolman, R. W. (2018) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999.0000000000000069 · Cited by 26 · see citing works
Buja, A., Toffanin, R., Claus, M., Ricciardi, W., Damiani, G., Baldo, V., & Ebell, M. H. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-020626 · Cited by 26 · see citing works
Bu, F., & Fancourt, D. E. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-07115-7 · Cited by 26 · see citing works
Validation of the PAM-13 instrument in the Hungarian general population 40 years old and above
Zrubka, Z., Vékás, P., Németh, P., Dobos, Á., Hajdú, O., Kovács, L., Gulàcsi, L., Hibbard, J. H., & Péntek, M. (2022) · The European Journal of Health Economics · doi:10.1007/s10198-022-01434-0 · Cited by 26 · see citing works
Self-citationFrosch, D. L., & Elwyn, G. J. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1560-1 · Cited by 25 · see citing works
Alexander, J., Hearld, L., & Mittler, J. N. (2014) · Medical Care Research and Review · doi:10.1177/1077558714541967 · Cited by 24 · see citing works
Patient Activation in Type 2 Diabetes: Does It Differ between Men and Women?
Hendriks, S. H., Hartog, L. C., Groenier, K. H., Maas, A. H. E. M., van Hateren, K. J. J., Kleefstra, N., & Bilo, H. J. G. (2016) · Journal of Diabetes Research · doi:10.1155/2016/7386532 · Cited by 24 · see citing works
Demoralization, Patient Activation, and the Outcome of Spine Surgery
Block, A. R. (2016) · Healthcare · doi:10.3390/healthcare4010011 · Cited by 24 · see citing works
Chylińska, J., Lazarewicz, M. A., Rzadkiewicz, M., Adamus, M. M., Jaworski, M., Haugan, G., Lillefjell, M., Espnes, G. A., & Włodarczyk, D. (2017) · BMC Geriatrics · doi:10.1186/s12877-017-0677-z · Cited by 24 · see citing works
Harris, A. B., Kebaish, F. N., Riley, L. H., Kebaish, K. M., & Skolasky, R. L. (2020) · Journal of Neurosurgery Spine · doi:10.3171/2019.11.spine191159 · Cited by 24 · see citing works
- Authors
- Remmers, C., Hibbard, J., Mosen, D. M., Wagenfield, M., Hoye, R. E., & Jones, C.
- Affiliations
- Kaiser Permanente (US)
- Venue
- Journal of Ambulatory Care Management
- Published
- 2009-10
- Volume
- 32
- Issue
- 4
- Pages
- 320-327
- ISSN
- 0148-9917 (ISSN-L)
- OpenAlex
- W2313471168
- Cited by
- 242
- References
- 18
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 14 · 2023: 15 · 2022: 15 · 2021: 15 · 2020: 16 · 2019: 14 · 2018: 26 · 2017: 23 · 2016: 21 · 2015: 17 · 2014: 20 · 2013: 14 · 2012: 4
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Ambulatory Care Management (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Keywords
- patient activation, Patient Activation Measure, diabetes mellitus, health outcomes, health care utilization, LDL cholesterol testing, hospital discharge, risk identification, patient engagement
- MeSH terms
- Diabetes Mellitus, Female, Humans, Male, Middle Aged, Patient Education as Topic, Patient Participation, Retrospective Studies, Self Care, Self Efficacy
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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