S0867 The Association Between Patient Activation and Health-Related Quality of Life Among Individuals With Crohn’s Disease

Abstract

INTRODUCTION: Patient activation (PA) is an individual’s knowledge, skill, and confidence in managing their health. There is limited data demonstrating higher PA is associated with better health-related quality of life (HRQoL) in patients (pts) with Crohn’s Disease (CD). METHODS: This study examined the association between PA and HRQoL in US adults with CD by analyzing data from Kantar’s US 2017 National Health and Wellness Survey (online self-administered survey). Stratified random sampling based on gender, age and race/ethnicity was used to ensure the sample was representative of the US adult population. PA was measured using the Patient Activation Measure (PAM®; 0–100 scale) that segments pts into 1 of 4 activation levels; higher levels represent higher activation: L1-disengaged and overwhelmed; L2-becoming aware but still struggling, L3-taking control and gaining control, L4-maintaining behaviors and pushing further. Sociodemographics and comorbidities were collected as covariates. HRQoL was assessed with SF-36v2. Minimal important difference (MID) was 3 points for mental and physical component summary (MCS and PCS) scores and 0.041 points for SF-6D health utilities index (derived from SF-36v2 items). Linear regression models compared differences in HRQoL between PAM levels without post-hoc adjustment while controlling for covariates. RESULTS: 374 respondents had a self-reported physician diagnosis of CD (mean age 49.4 years; 54.0% male. 23, 43, 175, and 133 respondents were PAM L1, L2, L3, and L4, respectively. Lower PAM was associated with younger age and greater comorbidity burden. After controlling for covariates, pts with PAM L1 vs. pts with PAM L4 had significantly lower MCS scores (P = 0.001) but did not have statistically significant differences on PCS scores (P = 0.090). Other health domains significantly lower for L1 vs. L4 groups were general health, physical functioning, role physical, vitality, social functioning, role emotional, and mental health (all P < 0.05). SF-6D was also significantly lower for L1 vs. L4. Differences between L1 and L4 met MIDs for PCS, MCS, and SF-6D metrics. Significant differences were also found between L2 and L4 on general health (P = 0.003) and vitality (P = 0.019). CONCLUSION: Lower PA was associated with poorer HRQoL. Pts with CD at the highest level of PA had meaningfully higher HRQoL scores than pts at the lowest level of PA. Future research should identity interventions that can improve levels of activation as it may help reduce HRQoL impairments.Table 1