December 26, 2018
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Patient activation linked to clinical remission in IBD

Patients with inflammatory bowel disease who were more knowledgeable about and had a more active role in the management of their disease experienced better disease severity, according to research published in Inflammatory Bowel Diseases.

Edward L. Barnes, MD, MPH, of the division of gastroenterology and hepatology at the University of North Carolina Chapel Hill, and colleagues wrote that increased patient activation has been associated with better outcomes, including improved adherence and less hospitalizations, in other diseases.

“Although patient activation has not been extensively investigated among patients with IBD, it is highly relevant given the strong desire of patients to be involved in their care and an increased emphasis on shared decision-making,” they wrote.

Researchers administered the Patient Activation Measure to 1,486 patients to determine the level of their activation at baseline and asked patients to return a follow-up survey within 13 months to assess what factors were associated with high or low activation and to explore any links between activation and disease activity.

After adjusting for education status, smoking, medication use and other factors, investigators found that patients with higher activation at baseline were more likely to be in clinical remission during follow-up (adjusted OR = 1.71; 95% CI, 1.2–2.45).

Patients with higher anxiety (aOR = 0.32; 95% CI, 0.29–0.36) and depression (aOR = 0.33; 95% CI, 0.29–0.37) were less likely to have high activation.

Barnes and colleagues wrote that because it is a modifiable factor, screening and interventions for activation could help improve care and outcomes for patients with IBD.

“Patients with IBD and high activation may be more adherent to therapies or may be more proactive in engaging in healthy behaviors such as exercise, all of which could lead to increased rates of remission,” they wrote. “Prospective interventional studies to evaluate the effectiveness of different strategies to improve patient activation are needed.” – by Alex Young

Disclosures: Barnes reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.