{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T00:11:56Z","timestamp":1793578316822,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patient activation describes the knowledge, skills and confidence in managing one's own health. Promoting patient activation is being prioritized to reduce costs and adverse outcomes such as cardiovascular disease (CVD). The increasing prevalence of chronic kidney disease (CKD) presents a need to understand the characteristics that influence patient activation and the effect on health outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and participants<\/jats:title><jats:p>Patients with non\u2010dialysis CKD recruited from 14 sites (general nephrology and primary care) in England, UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measures<\/jats:title><jats:p>Patient activation was measured using the PAM\u201013. Demographic and health\u2010related variables, self\u2010reported symptom burden, health\u2010related quality of life (HRQOL), socioeconomic status (SES), were assessed as determinants of patient activation. Major CVD risk factors included hypertension, dyslipidaemia, obesity and hyperkalaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>743 patients were included (eGFR: 32.3 (<jats:sub>SD<\/jats:sub>17.1)\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>, age 67.8 (<jats:sub>SD<\/jats:sub>13.9) years, 68% male). The mean PAM score was 55.1 (<jats:sub>SD<\/jats:sub>14.4)\/100. Most patients (60%) had low activation. Those with low activation were older (<jats:italic>P<\/jats:italic>&lt;.001), had lower eGFR (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.004), greater number of comorbidities (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.026) and lower haemoglobin (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.025). Patients with low activation had a 17% greater number of CVD risk factors (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Risk factors in those with low activation were being older (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and having diabetes (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study showed that only a minority of CKD patients are activated for self\u2010management. Our findings help better understand the level of activation in these patients, particularly older individuals with multimorbidity, and further the knowledge regarding the characteristics that influence activation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Patients were involved in the design of main study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.13225","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T11:10:15Z","timestamp":1617966615000},"page":"843-852","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Determinants of patient activation and its association with cardiovascular disease risk in chronic kidney disease: A cross\u2010sectional study"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7855-7752","authenticated-orcid":false,"given":"Thomas J.","family":"Wilkinson","sequence":"first","affiliation":[{"name":"Leicester Kidney Lifestyle Team Department of Health Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Memory","sequence":"additional","affiliation":[{"name":"Leicester Kidney Lifestyle Team Department of Health Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney J.","family":"Lightfoot","sequence":"additional","affiliation":[{"name":"Leicester Kidney Lifestyle Team Department of Health Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Palmer","sequence":"additional","affiliation":[{"name":"Leicester Kidney Lifestyle Team Department of Health Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice C.","family":"Smith","sequence":"additional","affiliation":[{"name":"Leicester Kidney Lifestyle Team Department of Health Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2017-007635"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l470"},{"key":"e_1_2_10_4_1","first-page":"1503","article-title":"Supporting self\u2010management in patients with chronic illness","volume":"72","author":"Coleman MT","year":"2005","journal-title":"Am Fam Physician"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1843-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2005.00438.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2004.00269.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2015.02.005"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359105320947790"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-011-1931-2"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2012.1061"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2019121331"},{"key":"e_1_2_10_13_1","unstructured":"The Renal Association.Transforming participation in chronic kidney disease.2019. 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