Integrated disease management (IDM) intervention for COPD patients has long-term effects on patient activation

Abstract

Background: Previous research suggests that the patient activation measure (PAM) score is related to health status, healthcare utilization and health behaviors. Little is known about changes in PAM among participants with severe COPD undergoing IDM interventions. Aims: To analyze whether changes in the PAM score were related to the COPD-Home IDM intervention and to measure the association between PAM and the Hospital anxiety (HADS-A) and depression (HADS-D) scores. Methods: COPD-Home is a single center, prospective, open, controlled clinical study. Differences in changes in the PAM score between the patients in the integrated care group (ICG) and the usual care group (UCG) at 6, 12 and 24 months after enrolment were assessed. Results: A clinically significant difference in the PAM score was achieved only in the ICG, 6.7 (CI95% 0.7 to 7.5) compared to 3.6 (CI95% -1.4 to 8.6) in the UCG. In a logistic regression model higher HADS-D score and current smoking significantly increased the odds for a lower PAM score (p=0.02 and p=0.02 respectively. Conclusion: The COPD –Home IDM intervention was associated with increased levels of activation among patients during 24 months of follow-up.