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Patient activation levels in cardiovascular disease: a cross-sectional study in Brazilian community pharmacies
Fabianna Marangoni Iglecias1, Eduardo Riano1, Francisco Javier Ferreira-Alfaya2
1Pharmacist, Ph.D. student, Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Granada, Granada, Spain.
Insights
Patient activation in Brazilian cardiovascular patients is moderate, with good adherence but low confidence in lifestyle changes. Physical activity positively impacts patient activation, suggesting lifestyle interventions can improve cardiovascular care outcomes.
Area of Science:
- Cardiology
- Public Health
- Health Psychology
Background:
- Cardiovascular diseases (CVDs) are a leading cause of premature death in Brazil.
- Preventable CVDs highlight the need for effective patient engagement strategies.
Purpose of the Study:
- To assess patient activation levels in individuals with cardiovascular disease within Brazilian community pharmacies.
- To identify factors influencing patient activation in this population.
Main Methods:
- A cross-sectional study involving 348 Brazilian participants with hypercholesterolemia and/or hypertension.
- Utilized the Patient Activation Measure (PAM-13) questionnaire, alongside sociodemographic, clinical, coronary risk, and quality of life assessments.
- Employed statistical analyses including t-tests, chi-square tests, and Pearson's correlation to examine relationships between variables.
Main Results:
- Participants had a mean age of 59.0 years with low to moderate cardiovascular risk.
- The average patient activation level was 2.8/4, indicating high self-care and adherence but lower confidence in sustaining lifestyle changes.
- Lower activation was associated with reduced physical activity, multiple chronic conditions, smoking, older age (>65), poor quality of life, and high coronary risk.
Conclusions:
- Patient activation in Brazilian cardiovascular care is positively influenced by lifestyle factors, especially physical activity.
- Intervention strategies focused on promoting lifestyle modifications are recommended to enhance patient activation and improve health outcomes.
Background:
Preventable cardiovascular diseases are among the leading causes of death in individuals aged < 70 years in Brazil.
Objective:
This study assessed the level of patient activation among individuals with cardiovascular disease in Brazilian community pharmacies.
Design And Setting:
This cross-sectional study included 348 Brazilian participants diagnosed with hypercholesterolemia and/or hypertension.
Methods:
The Patient Activation Measure (PAM-13) questionnaire was used. In addition, sociodemographic and clinical variables were collected, including coronary risk evaluation and quality of life assessment. Student's t-test was used to compare baseline quantitative variables between groups, and the chi-square test was used to assess associations for categorical variables. Pearson's correlation was used to examine the relationships among the quality of life, clinical variables, sociodemographic data, and activation levels.
Result:
Participants had an average age of 59.0 ± 16.7 years and a low to moderate risk. The mean patient activation level was 2.8 out of 4, with high self-care responsibility and treatment adherence but lower confidence in maintaining lifestyle changes. Factors linked to lower activity included low physical activity (P < 0.001), multiple chronic conditions (P = 0.003), smoking (P = 0.016), age > 65 years (P = 0.033), low quality of life (P < 0.001), and high CVR (P < 0.001).
Conclusion:
Patient activation in cardiovascular care in the Brazilian population is positively affected by lifestyle factors, particularly physical activity. Intervention strategies that promote lifestyle changes can enhance patient activity and improve health outcomes in this population.
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