Patient and Disease Characteristics Associated with Activation for Self-Management in Patients with Diabetes, Chronic Obstructive Pulmonary Disease, Chronic Heart Failure and Chronic Renal Disease : A Cross-Sectional Survey Study

A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6 +/- 10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for self-management: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater part of the factors that contribute to the complex nature of patient activation for self-management

Datafile Patient activation for self-management

This data set belongs to the manuscript “Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study”. The dataset is based on a survey consisting of patient characteristics and different health related questionnaires. For explanations of the variables see the Readme file

Linear regression analyses—univariable associations of the determinants with activation for self-management.

<p>CI = Confidence interval, BMI = Body Mass Index, DM-II = Diabetes Mellitus type II, COPD = Chronic Obstructive Pulmonary Disease, CHF = Chronic Heart Failure, CRD = Chronic Renal Failure.</p><p>Linear regression analyses—univariable associations of the determinants with activation for self-management.</p

Flowchart of recruitment.

<p>Flowchart of recruitment.</p

Distribution of PAM (patient activation measure) scores stratified by underlying chronic condition.

<p>DM-II = diabetes mellitus type 2, COPD = Chronic obstructive pulmonary disease, CHF = Chronic heart failure, CRD = Chronic renal disease.</p

Multivariable logistic regression analyses—determinants associated with poor activation for self-management.

<p>CI = Confidence interval, OR = Odds ratio, CI = confidence interval, BMI = Body mass index, SF-12 = short form-12, HADS = Hospital anxiety and depression scale, DM-II = Diabetes Mellitus type II, COPD = Chronic Obstructive Pulmonary Disease, CHF = Chronic Heart Failure, CRD = Chronic Renal Failure.</p><p>Multivariable logistic regression analyses—determinants associated with poor activation for self-management.</p