The key messages and finding of the paper include:
- Patient activation is a widely recognised concept. It describes the knowledge, skills and confidence a person has in managing their own health and health care.
- Patient activation is a better predictor of health outcomes than known socio-demographic factors such as ethnicity and age.
- People who are more activated are significantly more likely to attend screenings, check-ups and immunisations, to adopt positive behaviours (eg, diet and exercise), and have clinical indicators in the normal range (body mass index, blood sugar levels (A1c), blood pressure and cholesterol).
- Patients who are less activated are significantly less likely to prepare questions for a medical visit, know about treatment guidelines or be persistent in clarifying advice.
- Patient activation scores and cost correlations show less-activated patients have costs approximately 8 per cent higher than more-activated patients in the baseline year, and 21 per cent higher in the subsequent year.
- Studies of interventions to improve activation show that patients who start with the lowest activation scores tend to increase their scores the most, suggesting that effective interventions can help engage even the most disengaged.
The report outlines the Patient Activation Measure (PAM), a series of 13 statements designed to assess the extent of a patient’s activation. These statements are about beliefs, confidence in the management of health-related tasks and self-assessed knowledge. Patients are asked to rate the degree to which they agree or disagree with each statement. These answers are combined to provide a single score of between 0 and 100, which represents the person’s concept of themselves as an active manager of their health and health care.
The paper discusses studies that have examined the relationship between patient activation and health outcomes, and includes examples of programmes that have been designed to increase patient activation. These programmes include a range of supportive interventions to increase patients’ knowledge, skills and confidence in managing their health conditions.
The paper concludes with a series of policy implications including:
- Used in population segmentation and risk stratification, patient activation can provide new insights into risk that go beyond those using traditional socio-demographic factors.
- The PAM provides a simple, evidence-based mechanism for establishing the capacity of individuals to manage their health – and then using that information to optimise the delivery of care.
- Given the links between low levels of activation and poor health outcomes, the role of the PAM in addressing health inequalities in the United Kingdom should be considered further.
- It would be beneficial if the Department of Health and NHS England echoed calls for use of patient activation in England.
The paper can be read here.