A SYSTEMATIC REVIEW OF THE EVIDENCE FOR THE EFFECTIVENESS OF USING THE PATIENT ACTIVATION MEASURE (PAM) AS A TAILORING TOOL TO FACILITATE SELF-MANAGEMENT IN PATIENTS WITH A LONG TERM CONDITION

Abstract

Background Tailored self-management (SM) interventions are being implemented by health care professionals (HCP) to manage the growing number of people living with a long term condition (LTC). The patient activation measure (PAM) is a tool which measures how activated patients are in their own care, providing an activation score (level). It has been suggested SM programs can be tailored to patients PAM levels and provide tailored measurable support. However, at present the evidence for the PAM’s effectiveness of tailoring a SM program has yet to be reviewed. Aims The aim of this systematic review was to evaluate the current evidence regarding the effectiveness of the PAM as a tailoring tool for a SM intervention in patients with a LTC. Search strategy Pre-determined keywords were input into the following electronic databases: CINAHL, PEDro, PubMed, MEDLINE, Psychinfo, Scopus and Google Scholar. Grey literature and reference lists were hand searched. Selection criteria All study designs that met the pre-determined inclusion criteria which evaluated the effectiveness of PAM as a tailoring tool were accepted. Data collection and analysis The quality of the included articles were assessed using the following two tools: Effective Public Health Practice Project Assessment Tool and the Mixed Methods Assessment Tool. Once all the data was extracted a narrative synthesis was conducted. Main results Six weak to high quality studies met the criteria and were included in this review. These studies implemented SM interventions tailored by patients PAM levels. Numerous outcome measures were evaluated. Four out of the six studies reported that patient activation can improve and hospitalisation rates can decrease post a tailored intervention compared to normal care. All other results were inconclusive. Conclusion Based on this systematic review it may be suggested that PAM tailored SM programs can improve patient activation in own care and reduce hospitalisation rates for patients with a LTC. However, due to the lack of high quality studies and the disparities in other results no strong conclusions can be made. Further research is needed into the PAM as a tailoring tool before recommendations can be suggested.