The Effect of the Patient Activation Measure on Chronic Care
We will test - in a chronically ill managed long term care population - the effectiveness of an intervention that provides nurse Care Managers with an inventory of evidence-based practices tailored to patients with different levels of knowledge, skills and confidence to engage in self-care management. Specifically, we will develop a "change package" of evidence-based hypertension (HTN) management strategies geared to patients scoring at the four different stages of activation on the Patient Activation Measure (PAM). We will randomly assign a group of interdisciplinary teams in the managed long-term care plan to intervention or control status and will train the Care Managers on the Intervention teams to use the change package in conjunction with a patient's PAM score to design - with the involvement of the patient - an individualized HTN management plan. We then will assess the impact of the intervention on patient activation and outcomes.
Behavioral: Patient Activation Measure Intervention Package
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Using the Patient Activation Measure (PAM) to Improve Patient Self-Management of Hypertension|
- changes in patients' PAM scores [ Time Frame: six months ] [ Designated as safety issue: No ]
- differences in patients' HTN knowledge [ Time Frame: six months ] [ Designated as safety issue: No ]
- adherence to HTN medication and diet recommendations [ Time Frame: six months ] [ Designated as safety issue: No ]
- average changes in patients' systolic and diastolic BP [ Time Frame: six months ] [ Designated as safety issue: No ]
- percent of patients who maintain BP control, among those with controlled baseline BP [ Time Frame: six months ] [ Designated as safety issue: No ]
|Study Start Date:||April 2006|
|Study Completion Date:||March 2007|
|Primary Completion Date:||March 2007 (Final data collection date for primary outcome measure)|
The three main aims of the project are to:
- Determine whether the PAM-driven intervention increases patients' knowledge and self-management skills, measured by both generic PAM scores and HTN-specific measures developed by the research team.
Determine whether the PAM-driven intervention improves HTN patients' systolic and diastolic blood pressure (BP), measured in three ways:
- Average percent reduction in systolic and diastolic BP.
- Percent of patients who achieve BP control (defined as <140 systolic and <90 diastolic BP or <130 systolic and <80 diastolic for patients with diabetes or renal disease).
- Percent of patients with controlled HTN who maintain control.
Conduct an analysis to examine implementation of the intervention by trainers and Care Managers in the Intervention group and to understand the barriers and facilitators affecting the implementation process.
In addition, we will conduct a feasibility study with a subset of Care Managers to determine how the Visual Scan Assessment of Patient Activation might be incorporated into routine assessment and care planning procedures. Therefore, the fourth aim of the project is to:
- Assess the feasibility and perceived usefulness of the Visual Scan Assessment as a tool to increase feedback to Care Managers on how well they are supporting patient self-care management.
|United States, New York|
|Visiting Nurse Service of New York Center for Home Care Policy & Research|
|New York, New York, United States, 10001|
|Principal Investigator:||Linda M Gerber, Ph.D.||Weill Medical College of Cornell University|