The Effect of a Tailored Patient Activation Intervention in Inflammatory Bowel Disease Patients

Abstract

Purpose A pre-test, post-test, control group design was employed to investigate the impact of a tailored patient activation intervention (PAI) among inflammatory bowel disease (IBD) patients. Methods Patients who met the inclusion criteria were selected from medical records via convenience sampling, were consented, and completed a baseline survey. Based on responses to the baseline 13-item patient activation measure (PAM-13), they were categorized into one of four patient activation stages. During office visits, intervention patients (N=23) were given a tailored PAI based on their baseline stage, which consisted of an information booklet and focused discussion with the gastroenterologist, while the control group (N=27) received usual care. Baseline and 1-month post-intervention scores were compared between the intervention (N=20) and control (N=21) groups for changes in patient activation score, medication adherence, and satisfaction with care. Results Most participants were Caucasian (88%), female (64%), college graduates (56%), and had Crohn's disease (59.2%). Overall, females had a significantly higher (p=0.04) mean activation score (mean=70.9±15.4) than males (mean=60.9±10.7) at baseline. This trend was the same post-intervention (75.6 females vs 64.4 males; p=0.03). The difference in mean activation scores pre- vs post-intervention was not statistically significant between the intervention and control groups (mean=4.9±12.3, p=0.21). However, this difference could be considered to be clinically significant based on results from previous studies. There were no significant differences in medication adherence or satisfaction scores pre- vs post-intervention for either group. Conclusion Tailored PAIs have the potential to increase activation level of patients with inflammatory bowel disease. This customized medical interaction increased patient involvement in disease management and could potentially lead to improved health outcomes.

Impact of Pharmacist-Provided Education Using New Information Sheets on Activation in Patients Treated with Oral Antineoplastic Drugs (IMPACT-OAD Project)

“…Assuming a standard deviation (SD) of 15, based on the literature, a minimum sample size of 73 participants was required to detect a clinically meaningful difference of 5 points in the PAM score, with 80% power and 2-sided α of 0.05. 6,22,23 The data were normally distributed, and parametric tests were therefore used for all analyses. In the intention-totreat (ITT) analysis, a paired-observations t test was used to compare the mean pre-and post-intervention scores on the PAM-13 questionnaire.…”

Integrated Digital Patient Education at the Bedside for Patients with Chronic Conditions: Observational Study (Preprint)

“…Prior digital patient education studies have been conducted in patients undergoing or recovering from specific procedures, such as total joint arthroplasty and total hip replacement, endovascular aneurysm repair, peripheral angioplasty, catheter insertion procedures, endoscopy, and perioperative interventions, as well as in patients seeking to improve health conditions, including immunosuppression, oral health care, heart disease, lower back pain, asthma, and other conditions. It has been widely concluded that patients in specific medical contexts, receiving relevant content, have improved understanding as well as motivation to adhere to instructions when using digital learning formats, which in turn has led to higher levels of satisfaction among these patients [21,22,[26][27][28][29][30][31][32][33][34]. Computer-aided learning has been found to have positive impacts on the knowledge, attitude, behavior, and health of patients [27].…”