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 22[3] different languages. The measure is currently used to assess patient activation or engagement by researchers and clinicians around the world.[4][5][6][7] 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.[8][9][10][11][12][13][14][15][16][17][18] Higher activated individuals also have better health outcomes and lower rates of costly utilization, such as emergency department use and hospitalizations.[8][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. PMC 1361231. PMID 16336556. 
  3. ^ Judith Hibbard 27 July 2014 on http://e-patients.net/archives/2011/10/the-patient-activation-measure-pam-a-framework-for-developing-patient-engagement.html
  4. ^ 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. 
  5. ^ 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). 
  6. ^ 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. 
  7. ^ Steinsbekk, A (Oct 2008). "Patient Activation Measure". Tidsskr Nor Lageforen 128 (20): 2316–2318. 
  8. ^ a b 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 27 (5): 520–6. doi:10.1007/s11606-011-1931-2. 
  9. ^ 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. PMC 1955271. PMID 17610432. 
  10. ^ 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. 
  11. ^ 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. 
  12. ^ 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. 
  13. ^ 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. 
  14. ^ 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. 
  15. ^ 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. 
  16. ^ Rogvi, S; Tapager, Almdal, Schiotz, Willaing (April 2012). "Patient factors and glycaemic control -- associations and explanatory power". Diabetes Medicine. 
  17. ^ 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. 
  18. ^ 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. 
  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.