Navigation Links
Study: highly involved patients don't always see better health outcomes
Date:2/22/2008

Patients who prefer to be highly involved in their treatment don't necessarily have better luck managing chronic health conditions, a new study suggests.

A research team based at the Veterans Affairs (VA) Iowa City Health Care System and the University of Iowa surveyed 189 veterans with high blood pressure to determine the patients' preferences for involvement in their health care. They discovered those who wanted an active role in their treatment had higher blood pressure and cholesterol over a 12-month span than those who wanted a less active role.

The study, published this week in the Annals of Behavioral Medicine, was led by Austin Baldwin, a post-doctoral fellow in the Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the VA Iowa City Health Care System and an adjunct assistant professor of psychology in the UI College of Liberal Arts and Sciences.

"The intuitive assumption is that the more involved people are with their health, the better they'll be at managing chronic conditions. We found evidence to the contrary," Baldwin said. "Those who preferred a more 'patient-centered' or active role actually had higher blood pressure and lipid levels. Those who preferred a 'provider-centered' approach, in which the doctor is more authoritative, did better at managing their blood pressure and lipid levels."

Patients who preferred the most active role averaged a blood pressure of 141 over 79 and a low-density lipoprotein (LDL) cholesterol level of 112, while those who preferred the least active role averaged a blood pressure of 137 over 72 and an LDL of 92. Doctors tell most patients with high blood pressure to aim for a blood pressure less than 140 over 90 and keep LDL cholesterol under 130.

The average participant was 65.8 years old, and 97 percent were men. Participants were recruited from the Iowa City and Minneapolis VA health care systems and four affiliated community-based outpatient clinics as part of a larger hypertension trial. The data were collected in 2004.

The research team offered a couple potential explanations for the results.

One possibility is that patients who wanted an active role were dissatisfied with the relatively passive treatment of taking medication to control their conditions, and therefore may not have followed doctors' orders as well.

"They were presumably provided advice and guidance about modifying their lifestyle, but all of these patients were on hypertension medication, and many were on lipid-lowering medications," Baldwin said. "For those who want more control over their treatment, a relatively passive treatment like taking medication may not be a good match."

One aspect of the study gave traction to this explanation. Some patients were diabetic. While those who preferred an active role did worse at managing blood pressure and cholesterol, they did slightly better at managing blood sugar (although the effect on managing blood sugar was not statistically significant). Researchers believe that's because managing blood sugar is a more hands-on treatment involving blood sugar tests, diet regulation and sometimes medication.

Another potential explanation is that the patients' role preferences didn't match their doctors' role preferences. While this study did not assess providers' preferences, previous research suggests that a mismatch between patients' and providers' role preferences impacts adherence to treatment recommendations. (See related UI study at http://www.news-releases.uiowa.edu/2007/August/081007patient-centered.html.)

Baldwin said the research is important because if health professionals can assess patients' role preferences, they could potentially tailor treatment plans to give patients the best chance for a successful outcome. For example, patients with high blood pressure who want an active role could do better making more aggressive lifestyle changes and tracking their progress with a home blood pressure monitor, he said.

"The upshot of this research is that there isn't a one-size-fits-all approach. It's nice to think if we give everyone Treatment X, they're all going to do well," Baldwin said. "But individual differences and preferences are important, and the value of studying this is to understand how these preferences can influence treatment adherence and ultimately influence people's health."


'/>"/>

Contact: Nicole Riehl
nicole-riehl@uiowa.edu
319-384-0070
University of Iowa
Source:Eurekalert

Related medicine news :

1. UC study: New devices less effective in thwarting brain aneurysm recurrence
2. Study: low-income women more likely to suffer from postpartum depression
3. Study: Before a CT scan or angiogram, many people should take inexpensive drug to protect kidneys
4. Study: When it comes to physical activity, one size does not fit all
5. U of I study: exercise to avoid gallstones!
6. Geisinger study: PTSD a medical warning sign for long-term health problems
7. Study: Brain connections strengthen during waking hours, weaken during sleep
8. New Study: Screening for Problem Drinking is One of the Most Cost-Effective Clinical Preventive Services
9. New study: US ranks last among other industrialized nations on preventable deaths
10. Study: Short sleep times in patients with chronic medical diagnoses linked to obesity
11. New Lancet Study: Tobacco Control Measures Are Effective and Affordable Strategies to Reduce Chronic Disease Deaths Globally
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/22/2017)... Alpharetta, GA (PRWEB) , ... August 22, 2017 , ... ... across America, has awarded Zyclear Migraine Relief with the 2017 Women’s Choice Award. The ... as studies show that 3 out of 4 migraine sufferers are women. In a ...
(Date:8/22/2017)... , ... August 22, 2017 , ... ... (RCM) solutions, announced recently the availability of a new professional fee E/M leveling ... for their service to the healthcare industry. E/M coding is complex which supports ...
(Date:8/22/2017)... ... 2017 , ... “Without Love’s Beauty and Pleasures Life Does ... faced while hoping for a better life. “Without Love’s Beauty and Pleasures Life ... spent 13 years working with deprived/neglected adolescents and almost 20 years working with ...
(Date:8/22/2017)... ... August 22, 2017 , ... “Call Of Spiritual Duty”: a revelation in an ... author, C.S. Lizarde. Growing up on the streets of North Visalia, California, Carlos ... to apply the Biblical keys to his life, he noticed immediately that opportunities and ...
(Date:8/21/2017)... California (PRWEB) , ... August 21, 2017 , ... ... announcing the addition of two plastic surgery fellows for academic year 2017-2018, Christina ... for candidates who have successfully completed residency in Plastic and Reconstructive Surgery. ...
Breaking Medicine News(10 mins):
(Date:8/7/2017)... (NYSE: DPLO), the nation,s largest independent specialty pharmacy, announced financial ... unless otherwise noted, are to the quarter ended June 30, ... 2017 Highlights include: Revenue of $1,126 ... Total prescriptions dispensed of 220,000, compared to 241,000 ... Gross profit per prescription dispensed of $371, ...
(Date:8/3/2017)... , Aug. 3, 2017  Opioid addiction and ... driving up healthcare costs and threatening outcomes, were problems ... supply and IVD industry that support them, met this ... market researcher said that drugs of abuse, procalcitonin and ... sessions at the organization,s 69th meeting in ...
(Date:8/2/2017)... -- CaryRx, a next-generation full-service pharmacy, has announced the launch ... the Washington D.C. metropolitan area. CaryRx ... of medications through the convenience of its patient-friendly mobile app. ... one hour to any location in D.C. ... service to Washington D.C. ," says Areo ...
Breaking Medicine Technology: