A University professor is investigating whether people with chronic diseases such as congestive heart failure, asthma or diabetes can avoid frequent hospitalizations and high medical bills by knowing more about how to manage their diseases.
Judith Hibbard, a planning, public policy and management professor, is conducting the study along with the San Francisco-based disease management company LifeMasters Supported Self Care. Health Industry Forum, a consortium of large insurers and health care providers administered through Brandeis University in Waltham, Mass., has donated $190,000 to the study.
According to the forum’s Web site, Hibbard’s study is one of three studies across the country funded by the forum.
Hibbard specializes in the area of health policy. She has also studied the effect of consumer-driven health plans on consumer behavior, consumer understanding of Medicare policy changes and the impact of making hospital performance data publicly available.
For this study, Hibbard developed the Patient Activation Measurement (PAM), a test that measures patients’ beliefs, knowledge, confidence and behaviors regarding ability to manage health. Patients are asked whether they strongly agree, agree, disagree or strongly disagree with 13 statements such as “I know what each of my prescribed medications do.”
Hibbard said there has never been a tool to measure this concept across different diseases before and that there isn’t a lot of prior research on the issue.
LifeMasters provides telephone consulting to people with chronic diseases, where nurses give advice on how to improve health. Often this consulting is contracted through an employer or health care provider.
A team of behaviorists and psychologists develops techniques to make these phone calls more effective, LifeMasters executive chairwoman Christobel Selecky said.
All patients in Hibbard’s study will be administered the PAM by telephone. The control group and the experimental group will each include 1,700 patients from across the country. Selecky said the study has already started and will likely take a year to complete.
The outcome of the study will be based on medical bills and the number of times the patient is hospitalized during the study.
Nurses having weekly phone conversations with patients in the control group will not know the test results and will provide standard care.
In the experimental group, nurses will know the patients’ level of knowledge and adjust their conversations accordingly.
“If you’ve got someone who’s highly activated, you can immediately start working on the changes that need to happen,” Selecky said.
For those who score lower on the measurement and thus know less about their disease, Selecky said, efforts must first be focused on getting the patient to understand why lifestyle changes need to be made.
For example, if a patient is 30 pounds overweight, a nurse would discuss with the patient how he or she would be able to walk and breathe better after losing 30 pounds, Selecky said, rather than simply telling the patient to lose 30 pounds.
“The only way that you can get people to change behavior – is to build their self-confidence that they can have an impact on their lives,” Selecky said.

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