Patient Preference and Adherence (Dec 2018)
Patient activation in individuals with type 2 diabetes mellitus: associated factors and the role of insulin
Abstract
Heidi A van Vugt,1,2,* Anne Meike Boels,1,* Inge de Weerdt,2 Eelco JP de Koning,3 Guy EHM Rutten1 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, Utrecht, the Netherlands; 2Dutch Diabetes Federation, Amersfoort 3818 LE, the Netherlands; 3Department of Medicine, Leiden University Medical Center, 2300 RC Leiden, the Netherlands *These authors contributed equally to this work Aim: This study explored the relationship between insulin use and patient activation (a person’s internal readiness and capabilities to undertake health-promoting actions) in individuals with type 2 diabetes mellitus and aimed to identify demographic, clinical and psychosocial factors involved in patient activation.Methods: In this cross-sectional study, baseline data from a Dutch nationwide study were analyzed. Patient activation was assessed with the Patient Activation Measure 13. A linear mixed model was used to take clustering into account.Results: In total, 1,189 persons were included (310 of whom were on insulin), enrolled via 47 general practices and six hospitals. Their mean Patient Activation Measure 13 score was 59±12. We found no association between insulin therapy and patient activation. In the multivariable analysis, individuals with a better health status, very good or very poor social support (vs good social support), individuals who felt they had greater control over their illness and those with a better subjective understanding of their illness showed higher patient activation. Individuals with a lower educational level and those who expected their illness to continue showed a lower activation level.Conclusion: Patient activation does not differ between individuals with type 2 diabetes mellitus on insulin therapy and those on other therapies.Keywords: provider–patient communication, patient participation in health care, social support, patient activation, insulin therapy, psychological aspects, self-management
