title: Preferences for a patient-centered role orientation: association with patient-information-seeking behavior and clinical markers of health.
abstract: BACKGROUND
  Few data exist examining how patients' preferred role orientation (patient-centered or provider-centered) is associated with "patient-centered" behavior and clinical markers of health.
  
  
  OBJECTIVE
  The purpose of the study is to investigate how patients' preferred role orientation is associated with information-seeking behavior and clinical markers of health in a chronically ill population.
  
  
  METHODS
  Participants were 189 hypertensive patients, at two VA Medical Centers and four community-based clinics, who completed measures of preferred role orientation and medication information seeking. Lab values of patients' blood pressure, LDL cholesterol, and glycosylated hemoglobin A1c were used as clinical markers.
  
  
  RESULTS
  Preference for a patient-centered role was associated with seeking medication information from various sources (e.g., the internet [OR = 1.14, 95% CI = 1.05-1.23]) and with the number of sources from which patients obtained information (beta = .21, p = 0.005). However, patient-centered preferences were also associated with higher systolic blood pressure (beta = 0.16, p = 0.04), higher diastolic blood pressure (beta = .15, p = 0.04), and higher LDL cholesterol (beta = 0.17, p = 0.04). There was no association with glycosylated hemoglobin A1c (beta = -0.10, p = 0.36).
  
  
  CONCLUSIONS
  Patients who preferred a patient-centered role engaged in behavior consistent with their preferences, but had higher blood pressure and less favorable lipid levels. These findings are discussed in terms of the nature and treatment of certain chronic conditions that may explain why a patient-centered role orientation is associated with a less favorable clinical profile in some contexts.
authors.affiliation: The Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the Iowa City VA Medical Center, Iowa City, IA 52246-2208, USA. austin.baldwin@va.gov
authors.forename: Austin S
authors.initials: AS
authors.lastname: Baldwin
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Cvengros
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Christensen
authors.forename: Areef
authors.initials: A
authors.lastname: Ishani
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kaboli
mesh_terms: D022126:Access to Information; D000368:Aged; D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010819:Physician's Role / Q000523:psychology*; D011369:Professional-Patient Relations; D012803:Sick Role
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin