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Changes in Patient Activation in a Self-Management Intervention.

Leeza A Struwe1, Myra S Schmaderer1, Lani Zimmerman1

  • 1University of Nebraska Medical Center, Lincoln, USA.

Western Journal of Nursing Research
|May 17, 2019
PubMed
Summary

Individual patient change scores, not group means, better reflect outcomes from self-management interventions. Using point changes in patient activation measure (PAM) scores offers more refined analysis for tailoring patient care and evaluating intervention effectiveness.

Keywords:
PAM®cognitionhealth care utilizationmultimorbiditypatient activationquality of life

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Area of Science:

  • Health Services Research
  • Patient Self-Management
  • Health Outcomes Measurement

Background:

  • Patient activation is crucial for self-management and impacts health outcomes.
  • Measuring changes in patient activation requires appropriate analytical methods.
  • Existing research often relies on group means, potentially masking individual progress.

Purpose of the Study:

  • To compare the efficacy of different methods for analyzing changes in Patient Activation Measure (PAM) scores.
  • To evaluate individual level changes, point changes, and group means in outcome analysis.
  • To determine the most effective approach for assessing the impact of self-management interventions on healthcare utilization and quality of life.

Main Methods:

  • Analysis of PAM scores from 91 multimorbid patients completing a self-management intervention versus usual care.
  • Comparison of outcomes using individual PAM level changes, individual point changes (≥5 points), and mean group PAM scores.
  • Evaluation of healthcare utilization and health-related quality of life as outcome measures.

Main Results:

  • Individual point change scores provided a more refined analysis of patient activation changes compared to level changes.
  • Both individual change measures (level and point) were more reflective of actual patient progress than group means.
  • Self-management interventions showed potential benefits when analyzed using individual change scores.

Conclusions:

  • Individual change scores, particularly point changes, are superior to group means for analyzing patient activation in intervention studies.
  • Tailoring interventions and accurately measuring their impact necessitates the use of individual change scores.
  • Further research is recommended to optimize the use of PAM scores for clinical and healthcare outcome assessment.