Independent quantitative evaluation of the feasibility of using the Patient Activation Measure in the NHS in England

‘Patient activation’ describes the skills, confidence and knowledge a person has in managing her/his own health and health care. A growing body of evidence links ‘patient activation’ to improved health outcomes, lower costs and improved patient experience. 

The Patient Activation Measure (PAM) is a valid, reliable and commonly used tool for assessing patient activation through a questionnaire and can potentially be used as a patient generated outcome measure or as a method to tailor care to the needs of the patient. Five Clinical Commissioning Groups and the UK Renal Registry are piloting the PAM questionnaire for the first time in the NHS.

The Data Analytics team at the Health Foundation aims to be creative about the use of patient health records and other large scale datasets, while working at the intersection of health care delivery, policy analysis and methodology. Linking routine health care datasets to new measures of patient wellbeing, like PAM, will improve the understanding and management of the population’s health. 

Previous research has shown a link between low patient activation and increased usage of healthcare, both in primary and secondary care in the United States. It is assumed, based on this research, that patients with higher activation scores are more able to manage their own health and have less acute need for health care interventions. The PAM questionnaire has not had an equivalent evaluation in the NHS.

As part of the quantitative assessment of the PAM pilot, we will analyse linked pseudonymised data from routinely collected datasets in primary and secondary care. This pseudonymised dataset will contain the PAM score (if it has been completed by the patient), linked to each patient’s primary and secondary care usage.

Our analysis will answer the following questions:

• What are the primary and secondary care usage patterns of patients completing the PAM questionnaire?
• Do patients with different PAM scores show a differing pattern of primary and secondary healthcare utilisation?
• For patients who complete a subsequent PAM questionnaire, does PAM score change over time?   
• Does a change in PAM score correspond to a change in the primary and secondary healthcare usage of the patient?

The project is due to be completed in Autumn 2016 and our findings will be available after the completion of the project.

Contact details

If you would like more information about this project, please contact Dr Sarah Deeny and Dr Rebecca Pope.