Patient Activation Measure

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The Patient Activation Measure (PAM) is a commercial product which assesses an individual’s knowledge, skill, and confidence for managing one’s health and healthcare. Individuals who measure high on this assessment typically understand the importance of taking a pro-active role in managing their health and have the skills and confidence to do so.

The PAM survey measures patients on a 0-100 scale and can segment patients into one of four activation levels along an empirically derived continuum. Each activation level reveals insight into an array of health-related characteristics, including attitudes, motivators, behaviors, and outcomes.

Development and science[edit]

PAM was developed using qualitative methods, Rasch analysis, and classical test theory psychometric methods. Developed by Judith Hibbard and colleagues at the University of Oregon, the resulting 13-item measure is a uni-dimensional, interval level, Guttman-like scale.[1][2] The PAM has strong psychometric properties, and has been translated into 19 different languages. The measure is currently used to assess patient activation or engagement by researchers and clinicians around the world.[3][4][5][6] PAM is offered to healthcare organizations exclusively by Insignia Health, a company based in Portland, Oregon.

Research[edit]

Multiple studies show that PAM scores are predictive of most health behaviors, including preventive behaviors (e.g. obtaining screenings and immunizations); healthy behaviors (e.g. healthy diet and regular exercise); self-management behaviors (e.g. monitoring and medication management); and health information seeking.[7][8][9][10][11][12][13][14][15][16][17] Higher activated individuals also have better health outcomes and lower rates of costly utilization, such as emergency department use and hospitalizations.[18][19][20][21][22]

Further there is evidence that with support and appropriate interventions it is possible to increase activation levels in patients.[23][24][25][26][27]

The Patient Activation Measure is being used in a number of ways to improve the delivery of health care, including:

Use through Insignia Health[edit]

Insignia Health holds the worldwide exclusive rights to PAM per a technology transfer from University of Oregon. Insignia licenses PAM and other related products to organizations in the U.S. and abroad. PAM is being used in 16 countries today.

References[edit]

  1. ^ Hibbard, Judith; Stockard, Mahoney, Tusler (August 2004). "Development of the Patient Activation Measure (PAM): Conceptualizing and measuring activation in patients and consumers". Health Services Research 39 (4): 1005–10026. doi:10.1111/j.1475-6773.2004.00269.x. 
  2. ^ Hibbard, Judith; Mahoney, Stockard, Tusler (December 2005). "Development and testing of a short form of the patient activation measure". Health Services Research 40 (6): 1918–1930. doi:10.1111/j.1475-6773.2005.00438.x. 
  3. ^ Rademakers, Jany; Nijman, van der Hoek, Heijmans (31 July 2012). "Measuring patient activation in the Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13).". BMC Public Health 12: 577. doi:10.1186/1471-2458-12-577. 
  4. ^ Herrmann, W; Brenk-Franz, Hibbard, Freund, Djalali, Steurer-Stey, Sonnichsen, Storch, Schneider, Genischen (2012). "Evaluation of the German version of the Patient Activation Measure (PAM-13D) in the primary care setting". WONCA Europe (Vienna, Austria). 
  5. ^ Fujita, E; Kuno, Kato, Kokochi, Uehara, Hirayasu (2010). "Development and Validation of the Japanese Version of the Patient Activation Measure 13 for Mental Health". Seishingaku: 765–772. 
  6. ^ Steinsbekk, A (Oct 2008). "Patient Activation Measure". Tidsskr Nor Lageforen 128 (20): 2316–2318. 
  7. ^ Greene, Jessica; Hibbard (November 2011). "Why Does Patient Activation Matter? An Examination of the Relationship Between Patient Activation and Health-Related Outcomes". Journal of General Internal Medicine. 
  8. ^ Hibbard, Judith; Mahoney, Stock, Tusler (August 2007). "Do increases in patient activation result in improved self-management behaviors?". Health Services Research 42 (4): 1443–1463. doi:10.1111/j.1475-6773.2006.00669.x. 
  9. ^ Fowles, JB; Terry, Xi, Hibbard, Bloom, Harvey (October 2009). "Measuring self-management of patients' and employees' health: further validation of the Patient Activation Measure (PAM) based on its relation to employee characteristics". Patient Education and Counseling 77 (1): 116–122. doi:10.1016/j.pec.2009.02.018. 
  10. ^ Mosen, DM; Schmittdiel, Hibbard, Sobel, Remmers, Bellows (January–March 2007). "Is patient activation associated with outcomes of care for adults with chronic conditions?". Journal of Ambulatory Care Management 30 (1): 21–29. doi:10.1097/00004479-200701000-00005. 
  11. ^ Becker, ER; Roblin (August 2008). "Translating primary care practice climate into patient activation: the role of patient trust in physician". Medical Care 46 (8): 795–805. doi:10.1097/mlr.0b013e31817919c0. 
  12. ^ Hibbard, Judith; Cunningham (October 2008). "How engaged are consumers in their health and health care, and why does it matter?". Research Briefs 8: 1–9. 
  13. ^ Tabrizi, J; Wilson, O'Rourke (2010). "Customer Quality and Type 2 Diabetes from the Patients' Perspective: A Cross-Sectional Study". Journal of Research in Health Sciences. 2 10: 69–76. 
  14. ^ Rask, KJ; Ziemer, Kohler, Hawley, Arinde, Barnes (July–August 2009). "Patient activation is associated with healthy behaviors and ease in managing diabetes in an indigent populations". Diabetes Education 35 (4): 622–630. doi:10.1177/0145721709335004. 
  15. ^ Rogvi, S; Tapager, Almdal, Schiotz, Willaing (April 2012). "Patient factors and glycaemic control -- associations and explanatory power". Diabetes Medicine. 
  16. ^ Salyers, MP; Matthias, Spann, Lydick, Rollins, Frankel (November 2009). "The role of patient activation in psychiatric visits". Psychiatric Services. 11 60: 1535–1539. doi:10.1176/appi.ps.60.11.1535. 
  17. ^ Remmers, C; Hibbard, Mosen, Wagenfield, Hoy, Jones (October–December 2009). "Is patient activation associated with future health outcomes and healthcare utilization among patients with diabetes?". Journal of Ambulatory Care Management 32 (4): 320–327. doi:10.1097/jac.0b013e3181ba6e77. 
  18. ^ Greene, Jessica; Hibbard (November 2011). "Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related Outcomes". Journal of General Internal Medicine. 
  19. ^ Rogvi, S; Tapager, Almdal, Schiotz, Willaing (April 2012). "Patient factors and glycaemic control -- associations and explanatory power". Diabetes Medicine. 
  20. ^ Salyers, MP; Matthias, Spann, Lydick, Rollins, Frankel (November 2009). "The role of patient activation in psychiatric visits". Psychiatric Services 60 (11): 1535–1539. doi:10.1176/appi.ps.60.11.1535. 
  21. ^ Remmers, C; Hibbard, Mosen, Wagenfield, Hoye, Jones (October–December 2009). "Is patient activation associated with future health outcomes and healthcare utilization among patients with diabetes?". Journal of Ambulatory Care Management 32 (4): 320–327. doi:10.1097/jac.0b013e3181ba6e77. 
  22. ^ Begum, N; Donald, Ozolins, Dower (August 2011). "Hospital admissions, emergency department utilisation and patient activation for self-management among people with diabetes". Diabetes Research and Clinical Practice 93 (2): 260–267. doi:10.1016/j.diabres.2011.05.031. 
  23. ^ Lorig, K; Ritter, Laurent, Plant, Green, Jernigan (June 2010). "Online Diabetes Self-Management Program: A randomized study". Diabetes Care 33 (6): 1275–1281. doi:10.2337/dc09-2153. 
  24. ^ Druss, BG; Zhao, von Essenwein, Bona, Fricks, Jenkins-Tucker (May 2010). "The Health and Recovery Peer (HARP) Program: a peer-led intervention to improve medical self-management for persons with serious mental illness". Schizophrenia Research 118 (1-3): 264–270. doi:10.1016/j.schres.2010.01.026. 
  25. ^ Terry, PE; Fowles, Xi, Harvey (November–December 2011). "The ACTIVATE study: results from a group-randomized controlled trial comparing a traditional worksite health promotion program with an activated consumer program". American Journal of Health Promotion 26 (2): e64–73. doi:10.4278/ajhp.091029-quan-348. 
  26. ^ Shively, MJ; Gardetto, Kodiath, Kelly, Smith, Stepnowsky (February 2012). "Effect of Patient Activation on Self-Management in Patients with Heart Failure". Journal of Cardiovascular Nursing. 
  27. ^ Hibbard, Judith; Greene, Tusler (June 2009). "Improving the outcomes of diease management by tailoring care to the patient's level of activation". American Journal of Managed Care 15 (6): 353–360.