Patient Activation Impacts Quality of Life, Mental Health, and IBD Control

Patient activation level significantly affects quality of life (QOL), mental health status, and disease control among patients with inflammatory bowel disease (IBD), according to study findings published in Therapeutic Advances in Gastroenterology.

Patient activation encompasses a patient’s ability to independently perform daily activities, manage their own health, and participate in therapeutic processes.

Researchers conducted a retrospective cross-sectional study analyzing the effect of patient activation on measurements of health, using specific indices in 201 patients with IBD (women, 56.2%). Of these 201 patients, 75.6% had Crohn disease and 24.4% had ulcerative colitis.

Patients completed weekly questionnaires on their mobile smartphones. These questionnaires assessed clinical and emotional disease parameters, such as patient-reported levels of disease control using the IBD Control Questionnaire, QOL using the Short IBD Questionnaire (SIBDQ) and the patient-reported outcomes measurement information system (PROMIS-10), and patient activation using the Patient Activation Measurement (PAM-13).

The researchers collected additional clinical information from electronic medical health records, including patient demographics, IBD diagnosis type, surgical history, smoking status, current biologic medications, C-reactive protein levels, and fecal calprotectin levels. At least 96% of the patients received 1 biological therapy.

Most patients (79%) demonstrated high levels of patient activation, scoring level 3 or 4 on the PAM-13 questionnaire, while the remaining 21% scored level 1 or 2.

The researchers observed that patient activation levels via the PAM-13 correlated significantly with IBD control (P =.023) and QOL (SIBDQ: P =.010; PROMIS-10: P =.017). Subscores on the PROMIS-10 and SIBDQ indicative of mental health status also correlated significantly with PAM-13 scores (P =.0024).

“Due to the complexity and the long-term nature of this disease condition, patients’ ownership and involvement in managing their disease are of utmost importance to improve quality of life, preventing complications of the disease, and providing better functional and disease self-management,” the study authors wrote. “Patient activation is a relatively novel concept in IBD and these findings suggest that patient journals activation may play an important role in disease outcomes.”

Study limitations include the weakness of detected associations, the diverse and multifactorial nature of IBD, lack of widespread availability of inflammatory biomarkers, and inability to develop a predictive model for high patient activation measure levels due to small sample size.