title: The active patient role and asthma outcomes in an underserved rural community.
abstract: OBJECTIVE
  Patient activation, an individual's knowledge, skills, and confidence for managing their own health and health care, can play an important role in the management of chronic conditions. However, few studies have examined patient activation in underserved rural communities. The purpose of this study was to describe patient activation and examine how patient activation is associated with adherence to asthma maintenance medication and disease control in a low-income rural population with asthma.
  
  
  METHODS
  We conducted a cross-sectional telephone survey with 98 adults. Patient activation was assessed with the Patient Activation Measure. Adherence to long-term controller (LTC) medications and asthma control were examined using the Morisky Medication Adherence Scale (MMAS) and Asthma Control Test (ACT). Multivariate regression analyses were used to assess the associations between patient activation and: (1) adherence to LTC medications and (2) asthma control.
  
  
  RESULTS
  The majority of participants (50%) were classified in the highest level of patient activation. The least activated participants had lower mean MMAS and ACT scores in comparison to participants who were classified in higher patient activation levels. Multivariate analyses found significant positive associations between patient activation and adherence and asthma control.
  
  
  CONCLUSIONS
  Patient activation may be instrumental in low-income rural patients' use of asthma medication and disease control. Study results inform interventions to help patients use asthma medications appropriately and achieve better asthma control. In addition to increasing access to health care services in rural communities, health care professionals also may develop and implement strategies to positively impact rural patients' involvement in care.
authors.affiliation: Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, Wisconsin.
authors.forename: Henry N
authors.initials: HN
authors.lastname: Young
authors.forename: Tonja L
authors.initials: TL
authors.lastname: Larson
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Cox
authors.forename: Megan A
authors.initials: MA
authors.lastname: Moreno
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Thorpe
authors.forename: Neil J
authors.initials: NJ
authors.lastname: MacKinnon
mesh_terms: D001249:Asthma / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D055118:Medication Adherence; D008875:Middle Aged; D010358:Patient Participation; D011203:Poverty; D012424:Rural Population; D012648:Self Care; D011795:Surveys and Questionnaires; D014922:Wisconsin
keywords: asthma; patient activation; rural; self-management; underserved