Background Nowadays, patients are expected to be involved in their health care, well-informed and able to adjust their behavior to maintain a good health. Investigating patient activation and its relationships with patient characteristics and health-related outcomes will provide further insight into the gains to be expected if patients are more involved in their healthcare. Methods Based on claims data, 5,346 people were selected who received diabetes care in the last 12 months. They received a questionnaire including the Patient Activation Measure (PAM) and questions on patient characteristics, life style and self-management behaviors, knowledge about diabetes, healthcare utilization and own clinical values. We used bivariate analyses and regression analyses to investigate the relationships between patient characteristics, patient activation level, and health-related outcomes.

1. Diabetes Knowledge And Patient Activation Survey 2017
2. Diabetes Knowledge And Patient Activation Survey Form

Results Data of 1,845 (35%) people were used in the analyses. Patient activation differed depending upon several patient characteristics. Patient activation level was positively related to getting the recommended feet and eye examinations after controlling for several patient characteristics; no association was found for life-style and self-management behaviors and the other healthcare utilization measures. Those with a low patient activation level less often reported to have knowledge about diabetes and of their values on clinical indicators. Conclusions Among people with diabetes, patient activation level was especially related to disease-specific knowledge and less with health-related behavior and outcomes. The PAM might therefore especially be an useful instrument for clinical practice to identify patients most in need for diabetes education.

BMC Health Services ResearchRelationships between patient activation, disease-specific knowledge and health outcomes among people with diabetes; a survey studyMichelle Hendriks 0Jany Rademakers 00 NIVEL- Netherlands institute for health services research, PO Box 1568, 3500 BN Utrecht, the NetherlandsBackground: Nowadays, patients are expected to be involved in their health care, well-informed and able to adjust their behavior to maintain a good health. Investigating patient activation and its relationships with patient characteristics and health-related outcomes will provide further insight into the gains to be expected if patients are more involved in their healthcare. Methods: Based on claims data, 5,346 people were selected who received diabetes care in the last 12 months.

They received a questionnaire including the Patient Activation Measure (PAM) and questions on patient characteristics, life style and self-management behaviors, knowledge about diabetes, healthcare utilization and own clinical values. We used bivariate analyses and regression analyses to investigate the relationships between patient characteristics, patient activation level, and health-related outcomes. Results: Data of 1,845 (35%) people were used in the analyses. Patient activation differed depending upon several patient characteristics.

Patient activation level was positively related to getting the recommended feet and eye examinations after controlling for several patient characteristics; no association was found for life-style and self-management behaviors and the other healthcare utilization measures. Those with a low patient activation level less often reported to have knowledge about diabetes and of their values on clinical indicators. Conclusions: Among people with diabetes, patient activation level was especially related to disease-specific knowledge and less with health-related behavior and outcomes. The PAM might therefore especially be an useful instrument for clinical practice to identify patients most in need for diabetes education.Patient activation; Diabetes mellitus; Patient characteristics; Health-related outcomes-BackgroundPatients and especially the chronically ill are more andmore expected to be in charge of their own health and thehealthcare they receive. For one, several western countrieshave introduced some form of managed competition intheir healthcare system with the aim to accomplish a moreefficient and more patient-centered healthcare system.Patients are expected to take more responsibility, to informthemselves about existing treatments and differences inquality of care between healthcare providers, and to choosethe treatment and provider that best meet their needs.Also, the Chronic Care Model has been introduced tohelp healthcare providers to improve patients healthoutcomes 1,2. One important element is to accomplishproductive interactions that help patients to set goals andsolve problems for improved self-management. Healthcareprofessionals should mainly act as coaches, providingpatients with information and helping them to develop skillsto take a leading role 3,4.

Both these trends ask for activepatients; patients who are involved in their own healthcare, well-informed and able to adjust their behavior torealize or maintain a good health. For the chronically ill, itadditionally means employing self-management activitiessuch as monitoring ones condition, self-treatment andcoordinating the care of different providers 5.Diabetes is one of the most prevailing chronicconditions and a major cause of morbidity, disability andmortality 6.

Self-management has been recognized as animportant contributor to improved health outcomes forpeople with diabetes 7. However, not all people areequally well equipped to perform the variety of activitiesrequired for proper self-management. Educating andtraining people to fulfill the role of active patient isassumed to have positive effects on health outcomes. Itwill also most likely enhance the sustainability ofhealthcare systems.

More activated patients will be better ableto self-manage their disease leading to a lower uptake ofmore costly health care 7-9.In order to enhance the activation level of people withdiabetes or a chronic illness in general, an instrument isneeded to assess their abilities to manage their disease.Hibbard and colleagues developed the Patient ActivationMeasure (PAM) for this purpose. They define patientactivation as someones knowledge, skills, confidence andbehaviors needed for self-managing ones condition or health9,10. Research suggests that people go through fourstages of patient activation. At stage 1, people tend to beoverwhelmed and unprepared to play an active role, theyare predisposed to be passive recipients of care.

Diabetes Knowledge And Patient Activation Survey 2017

At stage 2,individuals lack knowledge and confidence forselfmanagement. At stage 3, people are beginning to takeaction but may still lack confidence and skills to supportnew behaviors. Finally, at stage 4, people have confidenceand perform adequate behaviors but may not be able tomaintain them in the face of stress.Patients with a higher activation level are more likely toengage in healthy behaviors such as regular exercise andproper diet, to engage in disease-specific self-managementbehaviors, to report medication adherence and to obtainpreventive care 8,11,12.

Higher patient activation alsoappears to be related with better biometrics such as bloodpressure and lipoprotein levels within a normal range andwith less hospitalizations and emergency department visits8. Several studies have shown that care tailored to apatients activation level as measured with the PAM resultedin improved values on clinical indicators, higheradherence to medication regimens and a reduction inhospitalizations and emergency department visits 8,13. Also,patient activation appeared to be modifiable and increasesin activation were followed by improvement inselfmanagement behaviors 13,14.Up till now, only a few studies focused on theactivation level of people with diabetes. These studies haveshown that patient activation is related to age, gender,race/ethnicity, self-reported health, duration and severityof the disease and comorbidity 6,7,15. Patientactivation was also related to life-style and self-managementbehaviors and healthcare utilization of people withdiabetes. Rask et al., for instance, found that more activepatients reported higher rates of weekly feet checks,getting recommended eye examinations, regular exercise andease of managing diabetes 15. An Australian studyrevealed that individuals with a lower patient activation levelwere more likely to have been hospitalized fordiabetesrelated complaints or to have visited the emergencydepartments 7.

So far, there has been one longitudinalstudy showing that a high activation level was predictiveof better rates for hemoglobin A1C (HbA1C) checkups,low-density lipoprotein cholesterol (LDL-C) checkups,HbA1C control and all-cause inpatient discharges 6.Patient activation did not predict lipid-lowering drug use,LDL-C control and hospital discharges with a primarydiagnose of acute myocardial infarction.In short, previous studies among diabetes patients haveshown that patient activation as measured with the PAMis related to patient characteristics and to health-relatedoutcomes. However, studies with the PAM are scarce,especially outside the USA.

Diabetes Knowledge And Patient Activation Survey Form

Investigating patient activationand its relationships with health-related outcomes indifferent patient groups and countries will provide furtherinsight into the gains to be expected if patients are moreinvolved in their healthcare. In this study, we focused onpeople with diabetes in the Netherlands and determinedthe relationships between patient characteristics,healthrelated outcomes and patient activation. We will answerthe following questions: (1) What is the activation level ofDutch people with diabetes; and (2) How does patientactivation relate to patient characteristics and self-reportedhealth-related outcomes in this group?MethodsSubjects and designAs part of a larger study on patients experiences withdiabetes care, 23,074 people who received diabetes care in2010 were selected from claims data of six healthinsurance companies. The health insurance companies selectedindividuals who claimed costs for diabetes care providedin 61 selected diabetes care networks from April toDecember 2010. Next, people younger than 18 years and/orwho were approached in the past 12 months for othersurveys on patient experiences were excluded. Each healthinsurance company randomly selected 300 patients perdiabetes care network.

If less than 300 patients receivedcare from one of the networks all patients were selectedwith a minimum of 80 patients per network. This resultedin the total of 23,074 people.The individuals received a paper questionnaire at homein the beginning of 2011 and non-respondents received upto three reminders (Dillman method) 16. Thequestionnaire included questions on patient characteristics,experience with diabetes care and health-related outcomes. Asubgroup of 5,346 people received a questionnaire thatalso contained the PAM. Ethical approval of the study wasnot necessary as research by means of surveys that are nottaxing or hazardous for patients (i.e.