Preoperative patient activation predicts minimum clinically important difference for PROMIS pain and physical function in patients undergoing elective spine surgery.
Spine J
; 23(1): 85-91, 2023 01.
Article
en En
| MEDLINE
| ID: mdl-36029964
ABSTRACT
BACKGROUND CONTEXT Patient activation is a patient's willingness to take independent actions to manage their own health care. PURPOSE:
The goal of this study is to determine whether preoperative patient activation measure (PAM) predicts minimum clinically important difference (MCID) for Patient-Reported Outcomes Measurement Information System (PROMIS) pain, physical function, depression, and anxiety for patients undergoing elective spine surgery. STUDY DESIGN/SETTING:
Retrospective review. PATIENT SAMPLE A single-institution, academic database of patients undergoing elective spine surgery. OUTCOMEMEASURE:
MCID at 1-year follow-up for PROMIS pain, physical function, depression and anxiety.METHODS:
We retrospectively reviewed a single-institution, academic database of patients undergoing elective spine surgery. Preoperative patient activation was evaluated using the PAM-13 survey, which was used to stratify patients into four activation stages. Primary outcome variable was achieving MCID at 1-year follow-up for PROMIS pain and physical function. Multivariable logistic regression analysis was used to determine impact of patient activation on PROMIS pain and the physical function.RESULTS:
Of the 430 patients, 220 (51%) were female with a mean age of 58.2±16.8. Preoperatively, 34 (8%) were in activation stage 1, 45 (10%) in stage 2, 98 (23%) in stage 3, and 253 (59%) in stage 4. At 1-year follow up, 248 (58%) achieved MCID for PROMIS physical function, 256 (60%) achieved MCID for PROMIS pain, 151 (35.28%) achieved MCID for PROMIS depression, and 197 (46%) achieved MCID for PROMIS anxiety. For PROMIS physical function, when compared to patients at stage 1 activation, patients at stage 2 (aOR3.49, 95% CI1.27, 9.59), stage 3 (aOR3.54, 95% CI1.40, 8.98) and stage 4 (aOR7.88, 95% CI3.29, 18.9) were more likely to achieve MCID. For PROMIS pain, when compared against patients at stage 1, patients at stage 3 (aOR2.82, 95% CI1.18, 6.76) and stage 4 (aOR5.44, 95% CI2.41, 12.3) were more likely to achieve MCID. For PROMIS depression, when compared against patients at stage 1, patients at stage 4 were more likely to achieve MCID (Adjusted Odds Ratio (aOR)2.59, 95% CI1.08-6.19). For PROMIS anxiety, when compared against patients at stage 1, stage 3 (Adjusted Odds Ratio (aOR)3.21, 95% CI1.20-8.57), and stage 4 (aOR5.56, 95% CI2.20-14.01) were more likely to achieve MCID.CONCLUSION:
Patients at higher stages of activation were more likely to achieve MCID for PROMIS pain, physical function, depression, and anxiety at 1-year follow-up. Routine preoperative assessment of patient activation may help identify patients at risk of poor outcomes.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Participación del Paciente
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Medición de Resultados Informados por el Paciente
Tipo de estudio:
Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Spine J
Asunto de la revista:
ORTOPEDIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos