About patient activation

The patient activation measure (PAM) is a measurement scale for the knowledge, skill and confidence a patient has in managing their health and care.  The PAM score is based on patients’ responses to 13 questions which include measures of individuals’ knowledge, beliefs, confidence and self-efficacy. Each activation level reveals insight into an array of health-related characteristics, including attitudes, motivators, behaviours and outcomes.

Clinicians have found that measuring patients’ activation levels gives them advantages in supporting patients. First, it provides an assessment to help clinicians identify those patients who need additional support. It lets them know where a patient is on the PAM scale and enables them to meet the patient there. Second, the score provides guidance on the type and amount of support that is likely to be helpful to the patient.

PAM has been extensively tested with reviewed findings from over 100 studies that quantified activation.  Activation varies within age, income, education groups and even among people with low literacy skills.  More importantly, targeted interventions have been shown to increase activation.  These typically focus on the patient gaining new skills or mastery and encouraging a sense of ownership of their health, often using peer support, changes in the patient’s social environment, health coaching and educational classes.

There is evidence 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