P0439 - How Do GERD Patients Make Decisions? Control Preferences & Patient Activation in Gastroesophageal Reflux Disease Patients

Sudharshan Achalu, BA, Rani Berry, MD, Meera Bhargava, MS, John O. Clarke, MD, George Triadafilopolous, MD, Afrin N. Kamal, MD, MS
Stanford University School of Medicine, Redwood City, CA

Introduction: Patient control preferences refers to their desired level of involvement in medical decision-making when selecting diagnostic and treatment choices. Patient activation refers to their ability to self-manage care. Understanding and respecting patient control preferences and promoting patient activation are critical in patient-centered care and improving health outcomes. In managing gastroesophageal disease (GERD), improving health outcomes is essential to limit risk of complications, including erosive esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. We aimed to quantify the degree of controlled preferences and patient activation among patients with GERD, applying the Control Preference Scale (CPS) and Patient Activation Measure (PAM).

Methods: We recruited 19 consecutive patients with GERD followed at Stanford Health Care Esophagus Center between March 2022 and June 2023. Inclusion criteria included adults (³18 years) with evidence of GERD [acid exposure time of ³6% on pH testing, esophagitis (LA grades B, C, or D), or Barrett’s esophagus. We excluded non-English speaking patients. Patients took an investigator-developed survey (Figure 1) with the following components: 1) Demographics, 2) CPS: A 5-item scale that categorizes patients into roles (Active, Collaborative, or Passive), and 3) PAM: A 13-item scale with score ranging between 1-100 that categorizes patients into one of four activation levels (e.g. Levels 3 & 4 indicates high patient activation).





Results: Ten patients (50% female), median age 65 [IQR 54-69]) with a diagnosis of GERD (Table 1) responded to the survey. Specific to CPS: Two patients (20%) preferred an Active role, making their final decision after seriously considering the provider’s opinion. Eight (80%) preferred a Collaborative role, sharing responsibility between patient and provider when selecting treatment options. When evaluating PAM, 7 patients (70%) had a mean PAM score 59.3, corresponding to PAM level 3. Two patients (20%) had a mean PAM score 78, corresponding to PAM level 4. One patient (10%) had a PAM score 45.3, corresponding to PAM level 1.

Discussion: Patients with GERD in our panel had both high control preferences and patient activation, suggestive of higher engagement in their care when managing the disease. Further studies are needed to explore whether levels of patient activation differ across populations and the impact of these scores on health outcomes in GERD.




Disclosures:


Sudharshan Achalu, BA, Rani Berry, MD, Meera Bhargava, MS, John O. Clarke, MD, George Triadafilopolous, MD, Afrin N. Kamal, MD, MS. P0439 - How Do GERD Patients Make Decisions? Control Preferences & Patient Activation in Gastroesophageal Reflux Disease Patients, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.