Chronic Disease

Personality factors play a role in responsiveness to disease self-management programs

Patients feel more effective in managing chronic diseases such as asthma, arthritis, and diabetes when they receive supportive home visits from individuals suffering from chronic diseases. However, the impact of this peer approach is moderated by personality factors, concludes a new study. In fact, measuring personality factors in chronically ill individuals may facilitate targeting of disease self-management interventions to those most likely to respond, suggest Anthony Jerant, M.D., and colleagues at the University of California, Davis School of Medicine. They recruited 415 adults with one or more chronic diseases from 12 offices and 70 family physician/internal medicine practices affiliated with a university-based primary care network.

Overall, 138 adults were randomly assigned to a control group of usual care that included an initial visit by a study nurse, 139 adults were assigned to a telephone peer intervention, and 138 were assigned to a home-visit peer intervention. Peer discussions involved topics such as exercising safely, use of relaxation techniques, coping with difficult emotions, and taking medications. All patients completed a 60-item version of the Five Factors Model of personality factors (neuroticism, extraversion, openness, agreeableness, and conscientiousness).

At the end of 6 weeks, chronic disease self-efficacy, measured on a 33-item scale, was significantly higher in the home-based group than in the phone-based and control groups. This effect waned by 6 months and disappeared within a year. However, personality factors moderated the effects of the support intervention. For example, lower self-efficacy was associated with higher levels of neuroticism and lower levels of conscientiousness, agreeableness, and extraversion. These patients benefited the most from the home intervention. The study was supported in part by the Agency for Healthcare Research and Quality (HS13603).

See "Five factor model personality factors moderated the effects of an intervention to enhance chronic disease management self-efficacy," by Peter Franks, M.D., M.P.H., Benjamin Chapman, Ph.D., Paul Duberstein, Ph.D., and Dr. Jerant, in the British Journal of Health Psychology 14(Pt. 3), pp. 473-487, 2009.

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