Patient Activation, Depressive Symptoms, and Self-Rated Health: Care Management Intervention Effects among High-Need, Medically Complex Adults

Cynthia F. Corbett
Kenn B. Daratha
Sterling McPherson
Crystal L. Smith
Michael S. Wiser
Brenda K. Vogrig
Sean M. Murphy
Roy Cantu
Dennis G. Dyck
Peer-Reviewed Article
May 2021


Randomized controlled trial of a care management intervention shows significant improvement in patient activation and self-rated health and decreased symptoms of depression in patients with complex needs.


Chronic care management models have shown success in improving care for people with complex health and social needs, but little is known about how these models impact patient activation, defined as patient knowledge, skill, and confidence for self-managing their health care. This randomized controlled trial compared patient activation outcomes of an in-person chronic care management intervention with a less intensive, telephonic social services referral intervention in adults with complex needs at a federally qualified health center.


Patient activation and self-rated health improved over time for both the in-person and telephonic intervention groups. Older participants who received the more intensive in-person intervention had significantly more improvements as compared to younger participants. Patients with depression experienced significant reductions in depressive symptoms and increases in patient activation over the course of both the in-person and telephonic interventions, but the more intensive in-person care management group experienced greater reductions. Other studies have shown an inverse relationship between patient activation and depression; i.e., reducing depressive symptoms may be necessary to improve patient activation.


Engaging patients with complex needs in comprehensive care management interventions can increase patient activation levels and decrease symptoms of depression, which may further impact patient activation.

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