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BMC Primary Care

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Open Access 01-12-2018 | Research article

Key attributes of patient centered medical homes associated with patient activation of diabetes patients

Authors: Lori A. Bilello, Allyson Hall, Jeffrey Harman, Christopher Scuderi, Nipa Shah, Jon C. Mills, Shenae Samuels

Published in: BMC Primary Care | Issue 1/2018

Abstract

Background

Approximately 24 million Americans are living with diabetes. Patient activation among individuals with diabetes is critical to successful diabetes management. The Patient Centered Medical Home (PCMH) model holds promise for increasing patient activation in managing their health. However, what is not well understood is the extent to which individual components of the PCMH model, such as the quality of physician-patient interactions and organizational features of care, contribute to patient activation. This study’s objective is to determine the relative importance of the PCMH constructs or domains to patient activation among individuals living with diabetes.

Methods

This study is a cross-sectional analysis of 1253 primary care patients surveyed with type II diabetes. The dependent variable, patient activation, was assessed using the Patient Activation Measure (PAM). Independent variables included 7 PCMH domains- organizational access, integration of care, comprehensive knowledge, office staff helpfulness, communication, interpersonal treatment and trust. Ordered logistic regression was performed to determine whether each PCMH domain was independently associated with patient activation, followed by a final ordered logistic regression that included all the PCMH domains in a single adjusted model.

Results

Using the full adjusted model, the odds of patients reporting higher activation scores (PAM) were found to be significant in the domains that represented organizational access (OR 1.56, 95% CI 1.31–1.85) and comprehensive knowledge (OR 1.44, 95% CI 1.13–1.85).

Conclusions

Many practices have struggled with the challenge to develop fully functional patient-centered medical homes. In an effort to become more patient-centered, this study aimed to address what factors activated diabetic patients to adhere to diabetes management plan. Understanding these factors can help identify PCMH attributes that practices can prioritize and improve upon to assist their patients in improving health outcomes.

Trial registration

Study was not a clinical trial; therefore it was not registered.

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Title: Key attributes of patient centered medical homes associated with patient activation of diabetes patients
Authors: Lori A. Bilello
Allyson Hall
Jeffrey Harman
Christopher Scuderi
Nipa Shah
Jon C. Mills
Shenae Samuels
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Primary Care / Issue 1/2018
Electronic ISSN: 2731-4553
DOI: https://doi.org/10.1186/s12875-017-0704-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Key attributes of patient centered medical homes associated with patient activation of diabetes patients

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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