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Published in: Annals of Behavioral Medicine 1/2008

01-02-2008 | Original Article

Preferences for a Patient-Centered Role Orientation: Association with Patient-Information-Seeking Behavior and Clinical Markers of Health

Authors: Austin S. Baldwin, Ph.D., Jamie A. Cvengros, M.A., Alan J. Christensen, Ph.D., Areef Ishani, M.D., Peter J. Kaboli, M.D., M.S.

Published in: Annals of Behavioral Medicine | Issue 1/2008

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Abstract

Background

Few data exist examining how patients’ preferred role orientation (patient-centered or provider-centered) is associated with “patient-centered” behavior and clinical markers of health.

Purpose

The purpose of the study is to investigate how patients’ preferred role orientation is associated with information-seeking behavior and clinical markers of health in a chronically ill population.

Methods

Participants were 189 hypertensive patients, at two VA Medical Centers and four community-based clinics, who completed measures of preferred role orientation and medication information seeking. Lab values of patients’ blood pressure, LDL cholesterol, and glycosylated hemoglobin A1c were used as clinical markers.

Results

Preference for a patient-centered role was associated with seeking medication information from various sources (e.g., the internet [OR = 1.14, 95% CI = 1.05–1.23]) and with the number of sources from which patients obtained information (β = .21, p = 0.005). However, patient-centered preferences were also associated with higher systolic blood pressure (β = 0.16, p = 0.04), higher diastolic blood pressure (β = .15, p = 0.04), and higher LDL cholesterol (β = 0.17, p = 0.04). There was no association with glycosylated hemoglobin A1c (β = −0.10, p = 0.36).

Conclusions

Patients who preferred a patient-centered role engaged in behavior consistent with their preferences, but had higher blood pressure and less favorable lipid levels. These findings are discussed in terms of the nature and treatment of certain chronic conditions that may explain why a patient-centered role orientation is associated with a less favorable clinical profile in some contexts.
Footnotes
1
To determine if the associations were affected by the time lag between the collection of the clinical lab values (i.e., LDL, HbA1c) and the PPOS assessment, we reran the analyses with the PPOS scores and the clinical markers controlling for the number of days between the two. This adjustment did not change the significance of the associations between patients’ PPOS scores and their LDL cholesterol values or their HbA1c values.
 
2
We reran all of the relevant analyses reported in this paper by limiting the analyses to those patients whose values were collected before the PPOS assessment (n = 112 for LDL, n = 80 for HbA1c) and then to those whose values were collected after the assessment (n = 45 for LDL, n = 23 for HbA1c). Because these analyses revealed that the associations were similar for both LDL cholesterol and HbA1c [as indicated by the size and direction of the standardized beta coefficients (b)] regardless of whether the clinical data were retrospective or prospective, we decided to include the most proximal value of these clinical markers in the analyses reported in the paper, regardless of whether it was collected before or after the PPOS assessment.
 
3
To determine if the associations were affected by managing multiple conditions, we reran the analyses controlling for the number of additional clinical values (i.e., LDL cholesterol, HbA1c) each patient had beyond their blood pressures (range: 0–2). This adjustment did not change the findings in any meaningful way.
 
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Metadata
Title
Preferences for a Patient-Centered Role Orientation: Association with Patient-Information-Seeking Behavior and Clinical Markers of Health
Authors
Austin S. Baldwin, Ph.D.
Jamie A. Cvengros, M.A.
Alan J. Christensen, Ph.D.
Areef Ishani, M.D.
Peter J. Kaboli, M.D., M.S.
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 1/2008
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-007-9011-x

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