Abstract: PUB057
Improving Outcomes for Kidney Patients by Increasing Patient Activation
Session Information
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Fleisher, Lee A., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Hibbard, Judith H., University of Oregon, Eugene, Oregon, United States
Background
Effective self-management is essential for patients who have chronic conditions, including kidney disease. Studies show that patient activation (PA), an individual’s knowledge, skills and confidence to manage their health is a critical factor in influencing outcomes in kidney patients. Using the Patient Activation Measure (PAM), a 13-item survey, kidney patients who score higher are more likely to follow treatment regimens and achieve better clinical outcomes. This presentation addresses: 1) How much difference can clinical teams make in helping patients gain self-management capabilities? 2) Does incentivizing clinicians make a difference in achieving greater gains in PAM scores, 3) Is it possible for patients who are sicker, older, and economically disadvantaged to make gains in their PAM scores?
Methods
Two populations were compared, a population receiving kidney care and whose patient care plans were designed to support greater PA, and a general population of patients who received ambulatory care, with no special intervention to increase PA. We examine gains in PAM scores over time in both populations and look specifically at gains among patients disadvantaged in some way.
Results
In the general care population, without tailored-interventions and no clinician incentive, PAM scores increased, but score improvement rarely reaches a 3-point threshold considered clinically meaningful. Findings from a forthcoming Lewin report will be discussed, showing gains in activation when clinicians are incentivized to support activation in patients with kidney disease (including dialysis and transplant patients). Average score change in the report [not publicly released yet] will be shared and compared to the average score change in general care population.
Conclusion
These findings highlight the important role that incentives play in directing the clinical team to help patients gain in PA, especially compared to those who are not incentivized. Findings indicate that patient characteristics were not key determinants of gains in activation: even those who are older, sicker, and economically-disadvantaged, made dramatic gains when clinicians are incentivized to support activation. Speakers will discuss the importance for insurers to provide financial incentives for clinicians to devote time and resources to activate chronic kidney disease patients, resulting in improved care and increasing equity in care
Funding
- Commercial Support – Phreesia