Observational studyHemodialysis international. International Symposium on Home Hemodialysis2022
Changes in patient activation in people starting dialysis: A prospective longitudinal, observational study.
Observational study in Hemodialysis international. International Symposium on Home Hemodialysis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Pooled it
- Breaking the cycle: patient activation role in improving diabetes self-care adherence for alleviating diabetes distress.The Libyan journal of medicine · 2026Article
- Rationale, design and baseline characteristics of a randomised controlled trial of Interventions to support Patient Activation for adults on hemoDialysis: the IPAD study protocol.BMC nephrology · 2026Article
- Feasibility and Acceptability of a Co-Designed Self-Management Programme for People Living With Kidney Failure.Journal of renal care · 2026Article
- Implementation and evaluation of a smartphone-based application for continuous ambulatory peritoneal dialysis (CAPD) patients: a prospective feasibility cohort study and collaborative effort of patients and the peritoneal dialysis team.Clinical kidney journal · 2025Article
- Vascular Access for Home Hemodialysis: A Perspective on Tunneled Central Venous Catheters at Home.Kidney medicine · 2025Review
- Factors associated with patient activation among patients with diabetes on hemodialysis: a multicenter cross-sectional study from a developing country.BMC nephrology · 2024Article
- Article
- Influence of Participation in a Medical-Themed Science Café on Patient Activation.Patient preference and adherence · 2023Article
- Changes in patient activation in people starting dialysis: A prospective longitudinal, observational study.Hemodialysis international. International Symposium on Home Hemodialysis · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIncreased patient activation is associated with improved health outcomes; however, little is known about patient activation in people with end-stage kidney disease at the start of their dialysis journey. This study aimed to measure activation status changes over the first 4 months of dialysis.
methodsProspective, longitudinal, and observational study. Incident patients initiating dialysis at 25 in-center hemodialysis and 17 home dialysis programs across three US states managed by the same dialysis provider completed the 13-item Patient Activation Measure (PAM-13) survey at baseline (month 1 after commencement of dialysis) and follow-up (month 4). The survey yields a score (0-100) that corresponds to four levels (1-4), with higher scores or levels indicating higher activation.
findingsOne hundred eighty-two participants (139 center, 43 home) completed both baseline and follow-up surveys. Mean age was 60 ± 15 years, 40% female. Mean PAM-13 scores were 65.1 ± 16.8 and 64.8 ± 17.8 at baseline and follow-up, respectively; mean intraindividual change: -0.3 ± 17.3. The proportions of patients at levels 1-4 at baseline were 11%, 23%, 35%, and 31% respectively. At follow-up, 50%, 64%, 52%, and 37% of participants at levels 1-4, respectively, changed to a different PAM level (Spearman correlation = 0.47; p < 0.001). Home dialysis was associated with higher PAM scores when compared to in-center hemodialysis in multivariable analyses, adjusted for sociodemographic variables, comorbidities, and predialysis nephrology care (β = 5.74, 95% confidence intervals [CI]: 0.11-11.37 and 9.02, 95% CI: 3.03-15.02, at baseline and follow-up, respectively). DISCUSSION: Although aggregated group scores and levels remained stable, intra-individual patient activation changed significantly during the first 4 months of dialysis. This novel finding is foundational to future projects aiming to design interventions to improve patient activation.
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