What are the determinants in Patient Activation Scores in COPD?

Abstract

Introduction: Patient Activation Measure (PAM) is a validated patient reported-measure (Hibbard J.H. et al. Health Serv Res. 2005 Dec; 40:1918-30) that captures a number of components of patient involvement, each of which is important for active engagement and participation. It is defined as ‘an individual’s knowledge, skill, and confidence for managing their health and heath care. Aim: To investigate which factors are associated with PAM scores in patients with COPD. Methods: 44 patients with COPD from the Knowsley Community Respiratory Service participated in pulmonary rehabilitation between June 2017 and October 2017. Patient activation was measured with the Patient Activation Measure (PAM) questionnaire. Results: There were 22 males and 22 females. The median age was 71 years (52-87 years), the median FEV1% predicted was 65 (27-117) and there were 9 current smokers (8 females versus 1 male). No associations were observed between baseline PAM FEV1% predicted (r=0.11, p=0.47), number of exacerbations in the last 12 months (r=-0.16, p=0.28), smoking status (median 53.2 smokers vs. 51 non-smokers, p=0.56) and age (r=-0.01, p=0.9). PAM was significantly improved following pulmonary rehabilitation (51.0 pre vs. 60.6 post, p=0.0019) with a median improvement of 7.4 points. Conclusion: PAM appears to be highly indivualised and is not associated with baseline characteristics of people with COPD. Pulmonary rehabilitation significantly improves PAM and further work is warranted to evaluate how improvements in PAM translate to long-term clinical outcomes.