H4All Social Prescribers complete a Patient Activation Measure (PAM) questionnaire with clients to provide insight on how they are managing their health and wellbeing and the type of interventions that would be most suitable for them.
Patient Activation is a widely recognised concept relating to the ability and knowledge a person has in managing their own health and wellbeing and is a fundamental part of NHS England’s Support for Self-Care Programme.
Assessing a patient’s level of activation is important because it allows us to assess a person’s self-management skills, identify who needs more support and tailor support and interventions to meet the individual needs of patients. Patient Activation can be used to reduce health inequalities and deliver improved outcomes, better quality care and lower health costs.
However Patient Activation is not something that is easily observable and cannot effectively be predicted using traditional socio-demographic factors such as ethnicity and age.
The Patient Activation Measure (PAM) survey provides a simple, evidence-based mechanism for establishing the capacity of an individual’s knowledge, skills and confidence to manage their own health and wellbeing. The PAM survey produces a score on a 100 point scale which is then assigned to one of four ‘levels of activation’ through the response to 13 statements.
Research has shown that individuals are more likely to make good decisions and take more action to promote their own health if they are engaged, informed, and feel confident they can take care of themselves. Those who have the skills and confidence to take on their personal health challenges experience fewer health crises and can slow or prevent functional declines. This translates to better health, and more effective and efficient use of healthcare resources.
As an example people who are ‘more activated’ are significantly more likely to adopt positive behaviours (e.g. diet and exercise), and have clinical indicators in the normal range (body mass index, blood sugar levels (A1c), blood pressure and cholesterol), and attend screenings, check-ups and immunisations.
Patients who are ‘less activated’ report more visits to the GP, are at significantly greater risk of hospital admission, significantly less likely to prepare questions for a medical visit, know about treatment guidelines or be persistent in clarifying advice.
Activation levels are changeable. With effective support, individuals can increase their level of activation over time moving patients away from being passive recipients of care to a collaborative relationship where they are 'active' partners in their own health and mental wellbeing.
To date, more than 240 peer-reviewed, published studies worldwide underscore the importance of activation and the PAM survey’s effectiveness in measuring activation to predict a broad range of health-related behaviours.
For further information on Patient Activation and people's ability to manage their own health and wellbeing, click on the link below: https://www.england.nhs.uk/personalisedcare/self-care/patient-activation-measure/
The Kings Fund has published, “Supporting people to manage their health – An introduction to patient activation”, which introduces the measure, the evidence and its application.
The evidence shows that more highly activated patients:
experience better health
have better outcomes and test results across a number of conditions
engage in healthier behaviour (correlated to smoking and obesity)
have fewer episodes of emergency care.