Patient Activation Measure

About the project

This pilot is testing the acceptability and feasibility of the Patient Activation Measure (PAM®) in Victoria.

PAM® is a validated patient reported outcome measure that health services and clinicians can use: 

• as a tailoring tool to deliver person-centred care
• for population segmentation and risk stratification
• as a measurement tool.

Objective

To understand the acceptability and feasibility of the PAM tool in the Victorian context.

Background

Chronic conditions are a leading cause of potentially preventable hospitalisations, with congestive heart failure, chronic obstructive pulmonary disease (COPD), and type 2 diabetes accounting for half of the potentially preventable hospitalisations for chronic conditions (AIHW, 2019). 

The PAM® supports increasing patient activation – a person’s ability to understand their health condition and self-manage their health – which has been demonstrated to align with better health outcomes, better care experiences and reduced unwarranted healthcare service utilisation, including a reduction in potentially preventable hospitalisations, in people with chronic disease (Janamian et al. 2022).

What is the PAM®?

The PAM® uses 13 questions to assess a patient’s knowledge, skills, and confidence in self-managing their own health. It places patients into one of four increasing levels of activation along a 100-point scale. An increase in a patient’s PAM® score within and between levels demonstrates an increase in patient self-management.

Solution design

We are working with participating health services to implement the PAM® as part of their existing chronic disease management programs.

In conjunction with CFEP and Insignia, we are providing participating health services with support and training to implement the PAM® via:

• online webinars
• self-paced eLearning modules
• support calls
• quarterly communities of practice. 

We also provide health services with a toolkit that includes guidance and best practice examples for implementing the PAM®.

Our impact so far

Health services are using PAM results to personalise care: 

• Conversations are guided by PAM scores to better understand the person’s lifestyles and circumstances and ensure any plans consider these.
• People with lower scores get more hands-on support, such as setting small achievable goals or joining peer programs.
• Clinicians adapt how they talk to patients, making it easier for people to understand their options, ask questions and make informed choices without feeling judged.
• Services re-check PAM scores every few months to track progress, adjusting support as people grow in confidence and capability.

Across Victoria, people are beginning to feel more confident in managing their health, and the results are encouraging. Early signs show PAM is helping to personalise care, reduce hospital use and improve quality of life. 

• 802 people have so far improved their PAM scores, often alongside better health results like lower blood sugar levels and more physical activity.
• Patients are reporting more confidence, stronger goal-setting and using more community supports to help feel empowered.
• Clinicians say patients are more engaged when care is matched to their activation level.

‘[PAM] allows me to … build trust and rapport and create a safe space for clients to explore ambivalence and gradually shift toward proactive decision-making.’ 

– Health service clinician

Pilot milestones

Participating services

• Access Health and Community
• Barwon Health
• cohealth
• EACH
• Echuca Regional Health
• Grampians Community Health
• healthAbility
• IPC Health*
• Latrobe Community Health
• Northeast Health Wangaratta
• Your Community Health