Background
Patient activation
Method
Outcome measure - patient activation
Predictor variables
Statistical analysis
Results
Descriptive data on PAM scores
Continuous Variables |
n
| Mean | SD |
Age | 4098 | 75 | 6.8 |
PAM Score
| |||
Baseline | 3539 | 60.83 | 15.4 |
6 month Follow Up | 2795 | 60.33 | 20.0 |
Depression | 4123 | 67.1 | 22.4 |
MULTIPleS
a
| |||
Summary Score | 1703 | 35.6 | 9.1 |
Treatment Burden | 1836 | 11.3 | 3.5 |
Prioritisation | 1898 | 11.1 | 2.9 |
Causal Role | 1831 | 6.3 | 2.2 |
Activity Restriction | 1928 | 7.0 | 2.5 |
n
| % | – | |
Gender
| |||
Male | 2023 | 46.6 | |
Female | 2315 | 53.4 | |
Number of LTC
| |||
1 LTC | 1115 | 25.5 | – |
2 or more | 2631 | 60.1 | |
Ethnicity
| – | ||
White British | 4123 | 95.4 | |
Living alone
| – | ||
Yes | 1594 | 36.9 | |
No | 2731 | 63.1 | |
Employment status
| |||
Working | 206 | 4.9 | – |
Retired/not economically active | 3985 | 93.8 | |
Other | 57 | 1.3 | |
Health Literacy
b
| – | ||
Never needs help | 2974 | 70.3 | |
Rarely needs help | 427 | 10.1 | |
Sometimes needs help | 455 | 10.8 | |
Often needs help | 158 | 3.7 | |
Always needs help | 215 | 5.1 | |
Social Support
| – | ||
Poor social support | 1392 | 33.6 | |
Good social support | 2755 | 66.4 |
Demographic Variable | PAM Level | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Level 1 | Level 2 | Level 3 | Level 4 | Total
n
| ||||||
N
| % |
N
| % |
N
| % |
N
| % |
N
| % | |
Gender
| ||||||||||
Male | 253 | 14.7 | 288 | 16.7 | 821 | 47.6 | 362 | 21.0 | 1724 | 47.8 |
Female | 332 | 17.6 | 353 | 18.7 | 857 | 45.4 | 344 | 18.2 | 1886 | 52.2 |
Living alone
| ||||||||||
Yes | 234 | 18.1 | 229 | 17.7 | 609 | 47.1 | 221 | 17.1 | 1293 | 35.9 |
No | 351 | 15.2 | 411 | 17.8 | 1070 | 46.3 | 480 | 20.8 | 2312 | 64.1 |
Employment status
| ||||||||||
Working | 13 | 7.6 | 24 | 13.9 | 86 | 50 | 49 | 28.5 | 172 | 4.6 |
Retired or not economically active | 553 | 16.5 | 603 | 17.9 | 1552 | 46.3 | 646 | 19.3 | 3554 | 94.3 |
Other | 15 | 36.6 | 4 | 9.8 | 17 | 41.5 | 5 | 12.2 | 41 | 1.1 |
Health Literacy
| ||||||||||
Never or rarely need help | 317 | 11.2 | 494 | 17.4 | 1392 | 48.9 | 639 | 22.5 | 2842 | 80.5 |
Sometimes or often need help | 108 | 29.1 | 77 | 20.8 | 150 | 40.4 | 36 | 9.7 | 371 | 10.5 |
Always need help | 144 | 45.3 | 59 | 18.6 | 90 | 28.3 | 25 | 7.9 | 318 | 9.0 |
Social Support
| ||||||||||
Poor social support | 251 | 22.1 | 226 | 19.9 | 517 | 45.5 | 142 | 12.5 | 1136 | 32.7 |
Good Social support | 318 | 13.6 | 397 | 16.9 | 1092 | 46.6 | 535 | 22.8 | 2342 | 67.3 |
Depression
| ||||||||||
Not Depressed | 180 | 8.8 | 309 | 15.1 | 1051 | 51.4 | 504 | 24.6 | 2044 | 57.2 |
Depressed | 393 | 25.7 | 333 | 22.8 | 605 | 39.6 | 198 | 12.9 | 1529 | 42.8 |
Number of LTC1 | ||||||||||
LTC 2 or more | 103 | 11.2 | 149 | 16.23 | 451 | 49.2 | 214 | 23.3 | 917 | 28.6 |
446 | 19.5 | 443 | 19.4 | 1019 | 44.6 | 376 | 16.5 | 2284 | 71.4 | |
Continuous Variables | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD |
Age in years | 76.4 | 8.1 | 74.9 | 6.7 | 74.3 | 6.5 | 73.1 | 6.1 | 75 | 6.8 |
Change in PAM scores over 6 months
PAM Level at Baseline | PAM Level at 6 Month Follow Up | ||||
---|---|---|---|---|---|
1 | 2 | 3 | 4 | Total | |
1 | 204 52.4 % | 78 20.1 % | 91 23.4 % | 16 4.1 % | 389 100 % |
2 | 93 19.8 % | 142 30.2 % | 188 40 % | 47 10 % | 470 100 % |
3 | 85 6.7 % | 176 13.9 % | 707 55.9 % | 298 23.5 % | 1266 100 % |
4 | 8 1.4 % | 23 4.1 % | 186 33.5 % | 339 61 % | 556 100 % |
Total | 390 14.6 % | 419 15.6 % | 1172 43.7 % | 700 26.1 % | 2681 100 % |
Predictors of Patient Activation at baseline
All Participants ( N = 3293) | Participants with >=2 LTCs (N = 1563) | |||||||
---|---|---|---|---|---|---|---|---|
Independent variable | b | 95% CI | Beta (β) |
p
| b | 95% CI | Beta (β) |
p
|
Age | -0.19 | -0.26 to -0.11 | -0.08 | 0.000 | -0.16 | -0.25 to -0.07 | -0.08 | 0.001 |
Gender
| ||||||||
Male | ||||||||
Female | -0.72 | -1.47 to 0.47 | -0.02 | 0.095 | -0.40 | -1.65 to 0.86 | -0.01 | 0.523 |
Living status
| ||||||||
Living with others | ||||||||
Living alone | 1.72 | 0.67 to 2.89 | 0.05 | 0.015 | 1.14 | -0.63 to 2.91 | 0.04 | 0.199 |
Work status
| ||||||||
Employed | ||||||||
Retired | -0.31 | -1.94 to 1.32 | 0.00 | 2.36 | -2.25 to 6.97 | 0.03 | ||
Other | 2.45 | -3.36 to 8.26 | 0.00 | 0.437 | 6.67 | -3.15 to 16.49 | 0.05 | 0.327 |
Health literacy
| ||||||||
Never needs help | ||||||||
Rarely needs help | -4.54 | -6.09 to -2.98 | -0.09 | |||||
Sometimes needs help | -4.58 | -6.25 to -2.90 | -0.09 | -3.57 | -5.66 to -1.48 | -0.08 | ||
Often needs help | -5.12 | -7.82 to -2.41 | -0.06 | -5.61 | -8.61 to -2.61 | -0.08 | ||
Always needs help | -9.56 | -12.80 to -6.32 | -0.13 | 0.000 | -9.86 | -13.94 to -5.78 | -0.17 | 0.000 |
Number of LTC | 0.03 | -0.27 to 0.32 | 0.00 | 0.846 | 0.72 | 0.31 to 1.13 | 0.08 | 0.001 |
Depression
| 0.09 | 0.06 to 0.12 | 0.13 | 0.000 | 0.08 | 0.04 to 0.12 | 0.11 | 0.001 |
HRQoL | 9.56 | 6.71 to 12.40 | 0.16 | 0.000 | 4.95 | 0.93 to 8097 | 0.09 | 0.017 |
Social Support | 4.32 | 3.14 to 5.50 | 0.13 | 0.000 | 3.73 | 1.78 to 5.68 | 0.12 | 0.000 |
MULTIPleS | - | - | - | - | -0.27 | -0.40 to -0.13 | -0.16 | 0.000 |
R2 0.168, Adjusted R20.164 | R2 0.176, Adjusted R2 0.169 |
Predictors of patient activation at baseline in patients with multimorbidity
Predictors of change in patient activation scores over 6 months
All Participants (N = 2709) | Participants with >=2 LTCs (N = 1273) | |||||||
---|---|---|---|---|---|---|---|---|
Independent variable | b | 95% CI | Beta (β) |
p
| b | 95% CI | Beta (β) |
p
|
Age | 0.03 | -0.11 to 0.16 | 0.01 | 0.678 | 0.01 | -0.12 to 0.15 | 0.01 | 0.851 |
Gender
| ||||||||
Male | ||||||||
Female | -0.23 | -1.78 to 1.32 | -0.01 | 0.762 | -0.76 | -2.85 to 1.33 | -0.02 | 0.466 |
Living status
| ||||||||
Living with others | ||||||||
Living alone | -0.40 | -2.21 to 1.40 | -0.01 | 0.654 | 1.04 | -0.72 to 2.80 | 0.03 | 0.239 |
Work status
| ||||||||
Employed | ||||||||
Retired | -3.44 | -8.03 to 1.15 | -0.04 | -6.89 | -12.74 to -1.03 | -0.08 | ||
Other | -4.59 | -13.32 to 4.14 | -0.02 | 0.259 | -1.00 | -12.88 to 10.88 | -0.01 | 0.03 |
Health literacy
| ||||||||
Never needs help | ||||||||
Rarely needs help | 0.21 | -2.66 to 3.10 | 0.00 | -0.22 | -3.43 to 2.99 | 0.00 | ||
Sometimes needs help | 0.53 | -1.44 to 2.50 | 0.01 | -0.07 | -2.77 to 2.62 | 0.00 | ||
Often needs help | -1.25 | -5.40 to 2.90 | -0.01 | -2.05 | -6.99 to 2.89 | 0.03 | ||
Always needs help | -1.20 | -4.61 to 2.25 | -0.11 | 0.824 | -2.29 | -6.12 to 1.54 | 0.03 | 0.665 |
Number of LTC | 0.29 | -0.20 to 0.78 | 0.02 | 0.242 | -0.08 | -0.82 to 0.64 | 0.01 | 0.807 |
Depression | 0.33 | -0.01 to 0.08 | 0.04 | 0.137 | 0.05 | 0.01 to 0.09 | 0.07 | 0.009 |
HRQoL | -3.84 | -8.15 to 0.46 | -0.05 | 0.078 | -0.46 | -5.41 to 4.50 | -0.01 | 0.852 |
Social Support | -3.20 | -1.90 to 1.25 | 0.01 | 0.683 | 0.73 | -1.83 to 3.30 | 0.02 | 0.566 |
MULTIPleS | - | - | - | - | 0.08 | -0.04 to 0.21 | 0.04 | 0.160 |
R2 = 0.00, Adjusted R2 = 0.00 | R2 0.01, Adjusted R2 = 0.00 |