Literature review on PAM scores 1. When all is said and done, I am the person who is responsible for managing my health condition 2. Taking an active role in my own health care is the most important factor in determining my health and ability to function Confidence and knowledge to take action 3. I know what each of my prescribed medications do 4. I am confident I can tell my health care provider concerns I have even when he or she does not ask 5. I am confident that I can tell when I need to go to get medical care and when I can handle a health problem myself 6. I know the lifestyle changes like diet and exercise that are recommended for my health condition 7. I am confident that I can follow through on medical treatments I need to do at home 8. I am confident that I can take actions that will help prevent of minimize some symptoms or problems associated with my health condition 9. I am confident that I can find trustworthy sources of inofrmation about my health condition and my health choices 10. I am confident that I can follow through on medical recommendations my health care provider makes, such as changing my diet or doing regular exercise 11. I understand the nature and causes of my health conditions(s) 12. I know the different medical treatment options available for my health condition Taking action 13. I have been able to maintain the lifestryle changes for my health that I have made 14. I know how to prevent further problems with my health condition 15. I know about the self-treatments for my health condition 16. I have made the changes in my lifestyle like diet and exercise that are recommended for my health condition 17. I am confident I can figure out solutions when new situations or problems arise with my health condition 18. I am able to handle symptoms of my health condition on my own at home Staying the course under stress 19. I am confident that I can maintain lifestyle changes like diet and exercise even during times of stress 20. I am able to handle problems of my health condition on my own at home 21. I am confident I can keep my health problems from interfering with the things I want to do 22. Maintaining the lifestyle changes that are recommended for my health condition is too hard to do on a daily basis Behaviors of higher PAM scores
Disease-specific behavior
REST API integration13 Most important PAM questionsPaper Development and Testing of a Short Form of the Patient Activation MeasureFindings:The results of the analysis indicate that the shortened 13-item version is both reliable and valid. PAM-13 questions: 1. When all is said and done, I am the person who is responsible for managing my health condition 2. Taking an active role in my own health care is the most important factor in determining my health and ability to function 3. I am confident that I can take actions that will help prevent or minimise some symptoms or problems associated with my health condition 4. I know what each of my prescribed medications do 5. I am confident that I can tell when I need to go get medical care and when I can handle a health problem myself 6. I am confident I can tell my health care provider concerns I have even when he or she does not ask 7. I am confident that I can follow through on medical treatments I need to do at home 8. I understand the nature and causes of my health condition(s) 9. I know the different medical treatment options available for my health condition 10. I have been able to maintain the lifestyle changes for my health that I have made 11. I know how to prevent further problems with my health condition - 12. I am confident I can figure out solutions when new situations or problems arise with my health condition 13. I am confident that I can maintain lifestyle changes like diet and exercise even during times of stress Paper:Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients' 'Scores' Findings: . Using patient activation levels to more effectively and appropriately support patients appears to be a potentially important way for delivery systems to improve outcomes and lower costs. Implementing interventions to increase patient activation, such as tailored coaching, have been shown to be feasible within the clinical Original PAM paper with 22 questionsFindings: There is wide agreement that engaging patients to be an active part of the care process is an essential element of the quality of care. Any serious attempts to improve this aspect of care will require three essential steps: (1) The development of a measure to assess patient activation; (2) The identification and use of evidenced-based interventions to increase patient activation; and (3) A method to hold providers and delivery systems accountable for supporting and increasing patient activation. The first step of developing a measure is necessary before the other two steps can be attempted. The Patient Activation Measure (PAM) appears to be a valid and reliable instrument to measure activation. PAM questions MethodologyThey used the convergence of the findings from a national expert consensus panel and patient focus groups to define the concept and identify the domains of activation. These domains were operationalized by constructing a large item pool. Items were pilot-tested and initial psychometric analysis performed using Rasch methodology. The third stage refined and extended the measure. The fourth stage used a national probability sample to assess the measure's psychometric performance overall and within different subpopulations. break down in 4 stages :(1) believing the patient role is important, (2) having the confidence and knowledge necessary to take action, (3) actually taking action to maintain and improve one's health, and (4) staying the course even under stress. Stage 1: Conceptualising Activation literature review and expert consensus process (qualitative approach). create a panel of 18 and 21 experts and gave them 2 sets of Qs. (2) Patients' focus group (10 and 9pts) were paid to answer 4 qs. results: Those who are activated believe patients have important roles to play in self-managing care, collaborating with providers, and maintaining their health. Stage 2: Preliminary Scale Development 80 item Qs (previous Qs and new ones) tested in pts with chronic conditions and F2F interviews. Pilot with 100 respondents who were paid for it. Psychometric Analysis using Rasch analysis ( The Rasch model, named after Georg Rasch, is a psychometric model for analyzing categorical data, such as answers to questions on a reading assessment or questionnaire responses, as a function of the trade-off between (a) the respondent's abilities, attitudes or personality traits and (b) the item difficulty.) Used probabilistic Guttman-like scale and Rasch person reliability and to assess validity they used Criterion Validity from the pilot study. Stage 3: Extension and Refinement of the Pam collected all the data and used Rasch rating scale model which yielded in the 21 PAM Qs. They also used calibrations (SEM: The standard error of measurement in the estimation of the item difficulty. SEM is the precision of the item difficulty estimation and is shown in 0–100 units. Infit: Infit mean square error is one of two quality control fit statistics assessing item dimensionality (the degree to which the item falls on the same single, real number line as the rest of the items). Infit is an information-weighted residual of observed responses from model expected responses and is most sensitive to item fit when the item is located near the person's scale location. Outfit: Outfit mean square error fit statistic is most sensitive to item dimensionality when the item scale location is distant from the person's scale location.) Stage 4: Testing with a National Sample pilot and Rasch analysis using the 22-item PAM using national sample data Paper : What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs Findings: The research shows that more activated patients have better health outcomes and better care experiences than patients who are less activated. The emerging evidence suggests a potentially new quality goal: increasing patient activation as an intermediate outcome of care that is measurable and linked with improved outcomes. There is evidence that raising patient activation scores results in improved health outcomes. Paper: Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients’ ‘Scores’ Findings: As health care delivery systems move toward assuming greater accountability for costs and outcomes for defined patient populations, having a clearer and more refined understanding of the factors that drive care costs and outcomes is needed. Using patient activation levels to more effectively and appropriately support patients appears to be a potentially important way for delivery systems to improve outcomes and lower costs. Implementing interventions to increase patient activation, such as tailored coaching, have been shown to be feasible within the clinical setting. There is evidence that raising patient activation scores results in improved health outcomes. However, entities that pay for and provide health care will ultimately want to know if improving activation in their patient populations translates into cost savings. The findings of this study begin to lay the foundation for an answer that important question |