Abstract
Objectives: To identify and characterize the constellation, or clusters, of self-management behaviors in patients with chronic obstructive pulmonary disease (COPD) and comorbid hypertension. Methods: Cluster analysis (n = 204) was performed with standardized scores for medication adherence to COPD and hypertension medications, inhaler technique, and diet as well as self-reported information on physical activity, appointment keeping, smoking status, and yearly influenza vaccination for a total of eight variables. Classification and regression tree analysis (CART) was performed to further characterize the resulting clusters. Results: Patients were divided into three clusters based on eight self-management behaviors, which included 95 patients in cluster 1, 42 in cluster 2, and 67 in cluster 3. All behaviors except for inhaler technique differed significantly among the three clusters (P's<0.005). CART indicated physical activity was the first differentiating variable. Conclusions: Patients with COPD and hypertensioncan be separated into those with adequate and inadequate adherence. The group with inadequate adherence can further be divided into those with poor adherence to medical behaviors compared to those with poor adherence to lifestyle behaviors. Practice Implications: Once validated in other populations, the identification of patient clusters using patient self-management behaviors could be used to inform interventions for patients with multimorbidity.
Original language | English (US) |
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Pages (from-to) | 627-633 |
Number of pages | 7 |
Journal | Patient education and counseling |
Volume | 104 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2021 |
Funding
Dr. Wisnivesky received consulting honorarium from Sanofi, GlaxoSmithKline and Banook and grants from Sanofi and Quorum. To the best of our knowledge, no conflict of interest, financial or other, exists for the other authors listed. Funding: This work was supported by the National Institutes of Health/National Heart, Lung, and Blood Institute [R01HL126508] and the National Center for Advancing Translational Sciences of the National Institutes of Health [TL1TR001434] (GM). GMPB, SC, BL, EB; Obtained funding: AF, MSW, JPW Support: Research grants from the National Institutes of Health/National Heart, Lung, and Blood Institute [ R01HL126508 ] and the National Center for Advancing Translational Sciences of the National Institutes of Health [ TL1TR001434 ] (GMPB).
Keywords
- Chronic Obstructive Pulmonary Disease
- Cluster Analysis
- Comorbidities
- Self-Management Behaviors
ASJC Scopus subject areas
- General Medicine