Patient Activation, Depressive Symptoms, and Self-Rated Health: Care Management Intervention Effects among High-Need, Medically Complex Adults

Cynthia F. Corbett, College of Nursing, University of South Carolina, Columbia, SC 29208, USA.
Kenn B. Daratha, School of Nursing & Human Physiology, Gonzaga University and Providence Sacred Heart Medical Center, Spokane, WA 99258, USA.
Sterling McPherson, College of Medicine, Washington State University, Spokane, WA 992002, USA.
Crystal L. Smith, College of Medicine, Washington State University, Spokane, WA 992002, USA.
Michael S. Wiser, CHAS Health, Spokane, WA 99202, USA.
Brenda K. Vogrig, CHAS Health, Spokane, WA 99202, USA.
Sean M. Murphy, Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA.
Roy Cantu, CHAS Health, Spokane, WA 99202, USA.
Dennis G. Dyck, Department of Psychology, Washington State University, Spokane, WA 992002, USA.

Abstract

The purpose of this randomized controlled trial (n = 268) at a Federally Qualified Health Center was to evaluate the outcomes of a care management intervention versus an attention control telephone intervention on changes in patient activation, depressive symptoms and self-rated health among a population of high-need, medically complex adults. Both groups had similar, statistically significant improvements in patient activation and self-rated health. Both groups had significant reductions in depressive symptoms over time; however, the group who received the care management intervention had greater reductions in depressive symptoms. Participants in both study groups who had more depressive symptoms had lower activation at baseline and throughout the 12 month study. Findings suggest that patients in the high-need, medically complex population can realize improvements in patient activation, depressive symptoms, and health status perceptions even with a brief telephone intervention. The importance of treating depressive symptoms in patients with complex health conditions is highlighted.