Tool to help patients manage their condition to be tested by NHS
A programme that measures a patient’s ability to manage their own health is about to be tested on 150,000 NHS patients in a two-year pilot study run by NHS England.
The Patient Activation Measure (PAM) is a test developed at the University of Oregon that employs qualitative methods, Rasch analysis, and classical test theory psychometric methods. It uses 13 measures to assess a patient’s confidence, skill and knowledge in managing their condition.
A patient is allocated points according to their responses to 13 statements. A patient’s overall score indicates their potential to participate actively in managing their own health.
It is hoped that the pilots, to be run by clinical commissioning groups, will show that the PAM improves health outcomes, saves money and tackles health inequalities.
The announcement of the pilots coincides with the publication of a report by the influential think-tank The King’s Fund. The report looks at how PAM has been used successfully in the United States and explores its potential impact on self-management in the United Kingdom.
It points to evidence that the higher a patient’s PAM score, the more likely they are to adhere to treatment and monitoring. Patients with higher scores are also likely to have fewer stays in hospital and visits to accident and emergency departments.
“Importantly, patient activation is not only linked to clinical and economic outcomes, but also to the patient’s experiences, with more highly activated patients having significantly more positive experiences of care,” the report says.
The pilots have been welcomed by community pharmacist Hemant Patel, secretary of the North East London Local Pharmaceutical Committee. The committee is behind a pilot project in north London in which community pharmacists are trained in the skills of health coaching to help them identify behaviours that need to change for a patient to successfully self-care.
Patel says that PAM could influence health outcomes, particularly with regard to medicines management. “I think it is very exciting and fits in well with the concordance agenda,” he says.
“It’s about using this tool to be more able to understand a patient’s thinking and develop personalised messages for these people that help them to improve their outcomes.”
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11138574
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