A happy female patient shaking hands with her doctor

Better health: the power of patient activation

According to a recent article in the Medical Journal of Australia, patient activation plays a crucial role in empowering people to take charge of their own health and self-care. We now understand the pursuit of improved health for all Australians involves more than just providing good medical care. As outlined in the Self-care for Health: a national policy blueprint, the importance of patient engagement in adopting positive health behaviours and actively participating in health and self-care cannot be underestimated. Patient activation, defined as an individual’s knowledge, skill and confidence in managing their health and healthcare, lies at the core of personalised care. This concept of patient activation is instrumental in achieving positive health outcomes, reducing unnecessary healthcare utilisation and improving both patient and provider experiences. The key to enhancing patient activation is the use of an evidence-based tool like the Patient Activation Measure (PAM®) survey.

Understanding patient activation

Patient activation is a behavioural concept encompassing an individual’s involvement in their health and healthcare decisions. It comprises knowledge, skills and confidence – all essential for active engagement and participation in self-care. Studies have shown that higher patient activation scores are associated with improved self-management behaviours, preventive measures and better clinical outcomes. On the other hand, patients with lower activation levels are more likely to have poorer clinical outcomes, higher hospitalisation rates and are less likely to adopt healthy behaviours.

The power of PAM®

The PAM® survey was created in 2010 and is the most widely used tool to assess patient activation. The PAM® has been extensively validated with diverse populations, across various languages, countries, age groups, genders, education levels and ethnicities. Search the Phreesia Research Library for more than two decades of research across 800+ published studies showing how increasing patient activation can help improve patient outcomes, lower costs and enhance the patient experience.

How PAM® works

The PAM® survey comprises 10 to 13 multiple-choice questions, depending on the version used and is typically self-administered by patients. The questions cover various aspects such as confidence in managing their health conditions, understanding medical information and their motivation to adopt healthy behaviours. A score ranging from 0-100 is determined based on the patient’s responses, and the patient is categorised into one of four activation levels, providing insights into their healthcare behaviours and decision-making abilities. The detailed assessment of activation enables the clinician to tailor their care and responses to better meet the needs of each individual patient.

Patient Activation Level infographic describing the four activation levels of a patient based on their PAM survey answers that provides insights into their healthcare behaviours and decision-making abilities. Level 1: Disengaged and overwhelmed, Level 2: Becoming aware but still struggling, Level 3: Taking action and gaining control, Level 4: Maintaining behaviours and pushing further.

The importance of tailoring care

By understanding a patient’s level of activation, clinicians can employ different communication techniques, interventions and strategies, providing appropriate support to improve self-care behaviours. The PAM® has shown that even a slight increase in a patient’s activation score can lead to considerable improvements in health outcomes and reduced healthcare costs. Studies have shown that even a single-point increase in a patient’s PAM® score can lead to a 3% improvement in health outcomes and a 3% reduction in healthcare costs. With targeted interventions, patients with lower activation levels can achieve significant changes in their scores within 4-6 months.

PAM® and the Quadruple Aim

Implementing the PAM® survey and employing PAM®-tailored interventions can lead to numerous benefits, including enhancing self-care and disease prevention, improving health outcomes, reducing healthcare costs and enhancing the experiences of both patients and care providers— encompassing the four essential elements of the Quadruple Aim.

For a quick overview of the PAM®, please watch this short video or discover more in our article What is patient activation? You can also read the published article from the Medical Journal of Australia at the National Library of Medicine.

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