Identifying Behavioral Phenotypes in Chronic Illness: Self-Management of COPD and Comorbid Hypertension

•Patients with multimorbidity create three distinct behavioral clusters.•A majority of patients perform self-management behaviors effectively.•Inadequate adherence can be differentiated by medical versus lifestyle behaviors.•Physical activity and medication adherence influenced cluster differentiation. To identify and characterize the constellation, or clusters, of self-management behaviors in patients with chronic obstructive pulmonary disease (COPD) and comorbid hypertension. Cluster analysis (n = 204) was performed with standardized scores for medication adherence to COPD and hypertension medications, inhaler technique, and diet as well as self-reported information on physical activity, appointment keeping, smoking status, and yearly influenza vaccination for a total of eight variables. Classification and regression tree analysis (CART) was performed to further characterize the resulting clusters. Patients were divided into three clusters based on eight self-management behaviors, which included 95 patients in cluster 1, 42 in cluster 2, and 67 in cluster 3. All behaviors except for inhaler technique differed significantly among the three clusters (P’s