PMID- 36029964 OWN - NLM STAT- MEDLINE DCOM- 20221216 LR - 20230207 IS - 1878-1632 (Electronic) IS - 1529-9430 (Linking) VI - 23 IP - 1 DP - 2023 Jan TI - Preoperative patient activation predicts minimum clinically important difference for PROMIS pain and physical function in patients undergoing elective spine surgery. PG - 85-91 LID - S1529-9430(22)00876-2 [pii] LID - 10.1016/j.spinee.2022.08.007 [doi] AB - BACKGROUND CONTEXT: Patient activation is a patient's willingness to take independent actions to manage their own health care. PURPOSE: The goal of this study is to determine whether preoperative patient activation measure (PAM) predicts minimum clinically important difference (MCID) for Patient-Reported Outcomes Measurement Information System (PROMIS) pain, physical function, depression, and anxiety for patients undergoing elective spine surgery. STUDY DESIGN/SETTING: Retrospective review. PATIENT SAMPLE: A single-institution, academic database of patients undergoing elective spine surgery. OUTCOME MEASURE: MCID at 1-year follow-up for PROMIS pain, physical function, depression and anxiety. METHODS: We retrospectively reviewed a single-institution, academic database of patients undergoing elective spine surgery. Preoperative patient activation was evaluated using the PAM-13 survey, which was used to stratify patients into four activation stages. Primary outcome variable was achieving MCID at 1-year follow-up for PROMIS pain and physical function. Multivariable logistic regression analysis was used to determine impact of patient activation on PROMIS pain and the physical function. RESULTS: Of the 430 patients, 220 (51%) were female with a mean age of 58.2+/-16.8. Preoperatively, 34 (8%) were in activation stage 1, 45 (10%) in stage 2, 98 (23%) in stage 3, and 253 (59%) in stage 4. At 1-year follow up, 248 (58%) achieved MCID for PROMIS physical function, 256 (60%) achieved MCID for PROMIS pain, 151 (35.28%) achieved MCID for PROMIS depression, and 197 (46%) achieved MCID for PROMIS anxiety. For PROMIS physical function, when compared to patients at stage 1 activation, patients at stage 2 (aOR:3.49, 95% CI:1.27, 9.59), stage 3 (aOR:3.54, 95% CI:1.40, 8.98) and stage 4 (aOR:7.88, 95% CI:3.29, 18.9) were more likely to achieve MCID. For PROMIS pain, when compared against patients at stage 1, patients at stage 3 (aOR:2.82, 95% CI:1.18, 6.76) and stage 4 (aOR:5.44, 95% CI:2.41, 12.3) were more likely to achieve MCID. For PROMIS depression, when compared against patients at stage 1, patients at stage 4 were more likely to achieve MCID (Adjusted Odds Ratio (aOR):2.59, 95% CI:1.08-6.19). For PROMIS anxiety, when compared against patients at stage 1, stage 3 (Adjusted Odds Ratio (aOR):3.21, 95% CI:1.20-8.57), and stage 4 (aOR:5.56, 95% CI:2.20-14.01) were more likely to achieve MCID. CONCLUSION: Patients at higher stages of activation were more likely to achieve MCID for PROMIS pain, physical function, depression, and anxiety at 1-year follow-up. Routine preoperative assessment of patient activation may help identify patients at risk of poor outcomes. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Sachdev, Rahul AU - Sachdev R AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Mo, Kevin AU - Mo K AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Wang, Kevin Y AU - Wang KY AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Zhang, Bo AU - Zhang B AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Musharbash, Farah N AU - Musharbash FN AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Vadhera, Amar AU - Vadhera A AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Ochuba, Arinze J AU - Ochuba AJ AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Kebaish, Khaled M AU - Kebaish KM AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Skolasky, Richard L AU - Skolasky RL AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. FAU - Neuman, Brian J AU - Neuman BJ AD - Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street JHOC 5241, Baltimore, MD 21287, USA. Electronic address: briann@wustl.edu. LA - eng PT - Journal Article DEP - 20220825 PL - United States TA - Spine J JT - The spine journal : official journal of the North American Spine Society JID - 101130732 SB - IM MH - Humans MH - Female MH - Adult MH - Middle Aged MH - Aged MH - Male MH - Retrospective Studies MH - *Patient Reported Outcome Measures MH - *Patient Participation MH - Minimal Clinically Important Difference MH - Pain MH - Treatment Outcome OTO - NOTNLM OT - MCID OT - PAM-13 OT - PROMIS OT - Pain OT - Patient activation OT - Physical function OT - Postoperative outcomes OT - Preoperative Assessment OT - Spine surgery EDAT- 2022/08/28 06:00 MHDA- 2022/12/17 06:00 CRDT- 2022/08/27 19:26 PHST- 2022/02/14 00:00 [received] PHST- 2022/07/21 00:00 [revised] PHST- 2022/08/17 00:00 [accepted] PHST- 2022/08/28 06:00 [pubmed] PHST- 2022/12/17 06:00 [medline] PHST- 2022/08/27 19:26 [entrez] AID - S1529-9430(22)00876-2 [pii] AID - 10.1016/j.spinee.2022.08.007 [doi] PST - ppublish SO - Spine J. 2023 Jan;23(1):85-91. doi: 10.1016/j.spinee.2022.08.007. Epub 2022 Aug 25.