A systematic review and meta-analysis of patient activation in people living with chronic conditions

Cuevas, Heather; Heitkemper, Elizabeth M.; Huang, Ya-Ching; Jang, Dong Eun; García, Alexandra; Zuñiga, Julie A.

doi:10.1016/j.pec.2021.02.016

Cited by 11 publications

(20 citation statements)

References 58 publications

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“…Across more than 700 published studies, the PAM has been extensively validated with diverse populations (in more than 30 languages and countries), covering different ages, genders, education, income and ethnicity, and including patients significantly affected by social determinants 19 . Further, the relationship between patient activation and health outcomes is well understood, and has been demonstrated across populations and health conditions 7 …”

Section: The Patient Activation Measure Survey Is the Most Common Mea...mentioning

confidence: 99%

“…Self‐care behaviour varies significantly depending on activation level. Higher PAM scores, regardless of illness type, are associated with improved patient self‐management behaviour (eg, medication adherence, healthy diet, engagement in regular exercise, and stress management) 3,6,7,20 . This is reflected in all types of preventive behaviour, meaning that a person’s activation level is a predictor of self‐care 6 .…”

Section: The Patient Activation Measure Survey Is the Most Common Mea...mentioning

confidence: 99%

“…At the lower end of activation, a 1‐point incremental change equates to an improvement in health outcomes of about 3% and a reduction in health costs of about 3%. It is expected that patients with lower activation levels (any group of patients and any chronic medical condition) would achieve a 7–10‐point change with targeted interventions within 4–6 months 7,9,22 …”

Section: The Patient Activation Measure Survey Is the Most Common Mea...mentioning

confidence: 99%

“…Using the PAM, the clinician can also determine how to gradually increase the patient’s knowledge, skill and confidence so that their health and wellbeing outcomes improve. By re‐administering the PAM every 3–6 months, clinicians can understand the impact of patient support strategies and programs much sooner than they would with traditional outcome measures 7 …”

Section: The Patient Activation Measure Survey Is the Most Common Mea...mentioning

confidence: 99%

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Activating people to partner in health and self‐care: use of the Patient Activation Measure

Janamian

Greco

Cosgriff

et al. 2022

Medical Journal of Australia

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Better health for all, through better self-care by all" is the vision of the Self-care for health policy blueprint. 1 We need this vision because medical care only partially contributes to overall health: 89% of health comes from genetics, behaviour, environment and social circumstancesall factors outside the clinical setting. 2 We see the influence of a person's behaviour on health outcomes in everything from preventing illness to managing long-term health conditions. 3 Therefore, it is vital that people are engaged with adopting positive health behaviour and partnering in health and self-care. The World Health Organization defines self-care as "the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health-care provider". 4 This concept of self-care incorporates the capability to care for oneself (knowledge, skills and confidence) as well as self-care activities. 1 The underlying determinants and enablers of self-care include factors beyond the individual, spanning environmental, economic and social factors. The importance of strategies to support self-care are captured in Australia's Primary Health Care 10 Year Plan. 5

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Section: The Patient Activation Measure Survey Is the Most Common Mea...mentioning

confidence: 99%

Section: The Patient Activation Measure Survey Is the Most Common Mea...mentioning

confidence: 99%

Section: The Patient Activation Measure Survey Is the Most Common Mea...mentioning

confidence: 99%

Section: The Patient Activation Measure Survey Is the Most Common Mea...mentioning

confidence: 99%

See 2 more Smart Citations

Activating people to partner in health and self‐care: use of the Patient Activation Measure

Janamian

Greco

Cosgriff

et al. 2022

Medical Journal of Australia

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“…Ensuring that patients are involved in and knowledgeable about their health is vital when addressing a chronic illness. Actively engaged patients are believed to be more adhered and self-disciplined ( 24 , 25 ), which facilitates them to embrace both clinical and psychosocial perspectives to manage chronic conditions and actively alter their lifestyle to diminish the harmful effects on health outcomes ( 26 ).…”

Section: Introductionmentioning

confidence: 99%

Satisfaction With Patient Engagement and Self-Reported Depression Among Hospitalized Patients: A Propensity-Score Matching Analysis

et al. 2022

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BackgroundDepression is common among hospitalized patients and poses a significant threat to their quality of life. Patient engagement (PE) in healthcare has been shown to be associated with positive health outcomes. However, the relationship between PE and depression among hospitalized patients, with and without chronic conditions, has not yet been explored. This study aimed to investigate the association between patients' satisfaction with PE and self-reported depression in Chinese public hospitals.MethodA multi-centered, cross-sectional survey was conducted in seven tertiary-level public hospitals in Guangdong province, China. Twelve items from a patient-centered care questionnaire and the Patient Health Questionnaire 2-item version were used were used to assess patients' satisfaction with PE and self-reported depression, respectively. Propensity score matching (PSM) approach was used to reduce selection bias and potential baseline differences between patients with and without chronic conditions. The relationship between satisfaction with PE and depression was assessed, using univariate and multivariate logistic regression analyses, respectively.ResultsA total of 1,974 hospitalized patients participated in the survey. After the PSM procedure, 604 patients were assigned to the chronic condition group, and another 604 patients were successfully matched in the comparison group with no differences in sex, age, educational level, and PE-related characteristics. Univariate logistic regression analysis indicated that high satisfaction with PE-related approaches significantly decreased the probability of developing depressive status. Multivariate logistic regression analysis further indicated that, after adjusting all PE-related approaches, “patient education” and “involvement in discharge planning” could significantly decrease the probability of patients developing depression.ConclusionsOur results indicate that encouraging PE and improving patients' satisfaction with PE interventions in clinical practice led to improved mental health outcomes among hospitalized patients in China.

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Patient activation for self‐management among adult patients with multimorbidity in primary healthcare settings

Paukkonen

Oikarinen

Kähkönen

et al. 2022

Health Science Reports

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Background and Aims: Multimorbidity is a major public health and healthcare challenge around the world, including in Finland. As multimorbidity necessitates selfmanagement in everyday life, the effects of patient activationa patient's knowledge, skills, and confidence in managing own healthon the capacity for self-management warrant study, especially in primary healthcare settings. This study aimed to assess patient activation among multimorbid primary healthcare patients, identify factors associated with patient activation, and determine whether patients with low and high activation differ in terms of health and self-management behavior, related perceptions, and health-related quality of life (HRQoL).Methods: A cross-sectional survey was conducted among multimorbid patients who attended Finnish primary healthcare consultations (November 2019 to May 2020).The main outcome, patient activation, was assessed using the patient activation measure, PAM-13 ® . Responses from 122 patients were analyzed using descriptive statistics, t-tests, analysis of variance, linear modeling, the χ 2 test, and binary regression analysis. Results:The mean score of patient activation was 56.12 (SD 12.82) on a scale 0-100 where ≤55.1 indicate low activation. The lower activation scores were significantly associated with old age, obesity, loneliness, and lower perceived health, functional ability, and vitality. Patients with low activation (47%) had significantly poorer physical activity, diets, adherence to care, and HRQoL, and significantly worse perceptions related to self-management including motivation and energy, sense of normality, and support from physicians, nurses, and close people. Conclusion: Patient activation among multimorbid outpatients was rather low. Findings indicate that patients' perceptions of their health and psychosocial factors may be important for activation and that patients with low and high activation differ with respect to several health variables. Determining patient activation in multimorbid patients may facilitate adaptation of care to better meet patient capabilities and needs in clinical settings. Knowledge of a patient's activation level

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A systematic review and meta-analysis of patient activation in people living with chronic conditions

Cited by 11 publications

References 58 publications

Activating people to partner in health and self‐care: use of the Patient Activation Measure

Activating people to partner in health and self‐care: use of the Patient Activation Measure

Satisfaction With Patient Engagement and Self-Reported Depression Among Hospitalized Patients: A Propensity-Score Matching Analysis

Patient activation for self‐management among adult patients with multimorbidity in primary healthcare settings

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