Patient activation is increasingly recognized as a critical variable in promoting self-management, treatment adherence, and treatment planning satisfaction. Chiara Acquati, PhD, and colleagues explored the relationship between patient activation and treatment decision-making. Furthermore, based on the role informal caregivers play in patient-reported outcomes, the investigators evaluated whether the involvement of caregivers played a role in moderating the relationship.
From 504 cancer survivors, online consumer panels were used to collect survey data regarding treatment options, quality of life, adherence to treatment, next to presence and informal caregiver involvement. Also included were the Patient Activation Measure, and sociodemographic and clinical questions. The investigators used structural equation modeling to examine the relationship between the Patient Activation Measure scores, caregiver involvement, and the identified outcomes.
Survey respondents were mostly non-Hispanic white (72.9%), women (57.1%), and middle-aged or older adults (68%) who were aged ≥55 years. Colorectal cancer (8.3%), early-stage breast cancer (9.7%), gynecologic cancer (8.9%), and prostate cancer (16.3%) were the 4 largest cancer type groups. More than half (52.0%) of the survey respondents had been diagnosed >4 years previously. There was an even split of participants who had been treated at a community hospital (31.7%) compared with an academic cancer center (29.4%). There was a significant association between patient activation and treatment planning being reflective of survivors’ goals and values (P <.001), adherence to treatment (P = .011), and satisfaction (P <.001). The association between activation and adherence to treatment was significantly moderated by caregiver involvement. There was a positive association with all 3 selected outcomes and patient activation. Yet, patient activation was not associated with treatment adherence for cancer survivors reporting low rates of caregiver engagement. There is a need for further investigation to develop and test patient activation interventions that include informal caregivers for enhancing self-management.
Acquati C, Hibbard J, Sonet EM, et al. The moderating role of informal caregivers’ involvement on the relationship between patient activation and adherence to treatment: implications for self-management intervention in cancer care. Presented at: American Society of Clinical Oncology 2021 Annual Meeting, June 4-8. Abstract 12083.