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 (beta = .21, p = 0.005). However, patient-centered preferences were also associated with higher systolic blood pressure (beta = 0.16, p = 0.04), higher diastolic blood pressure (beta = .15, p = 0.04), and higher LDL cholesterol (beta = 0.17, p = 0.04). There was no association with glycosylated hemoglobin A1c (beta = -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.
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 hypertensivepatients, 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 (beta = .21, p = 0.005). However, patient-centered preferences were also associated with higher systolic blood pressure (beta = 0.16, p = 0.04), higher diastolic blood pressure (beta = .15, p = 0.04), and higher LDL cholesterol (beta = 0.17, p = 0.04). There was no association with glycosylated hemoglobin A1c (beta = -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.
Authors: Judith E Arnetz; Ulrika Winblad; Anna T Höglund; Bertil Lindahl; Kalle Spångberg; Lars Wallentin; Yun Wang; Joel Ager; Bengt B Arnetz Journal: Health Expect Date: 2010-06-23 Impact factor: 3.377