OBJECTIVES: Patient activation (measured using Patient Activation Measure questionnaire [PAM]) is a treatable trait in chronic airway diseases. Increased patient activation is associated with improved health outcomes, and reduced disease burden and, subsequently, healthcare resource utilisation. This study aims to highlight changes in patient activation in an international cohort utilising PAM, and provide rationale for said changes.

METHODS: Patients in an international online moderate-to-severe asthma community (n=125; France, Germany, Italy, Spain, Japan, USA) responded to a PAM survey. The survey, conducted in 2023 and 2024, included 13 quantitative statements; results were grouped into activation levels (1-4; higher level=better outcome).

RESULTS: In both years, the overall PAM level was 2.8. Italy, Germany and the USA increased from 2023 to 2024 (2.8→3.0, 2.9→3.0, 3.1→3.2, respectively); Japan remained at 2.1; France and Spain decreased (3.1→2.7, 3.0→2.8, respectively). Responses remained broadly consistent between years, with all countries continuing to agree with most of the condition ownership, medical confidence and proactive/preventive statements. Statements on condition ownership (84-94% agreement) and medical confidence (85-93%) were the strongest both years. However, small declines were recorded for some statements, notably patients’ understanding of prescribed medication (5/6 countries). Scores on ability to proactively manage/prevent health issues were the lowest (77-89%). Japan’s lowest scores related to maintaining lifestyle changes (37-58%). Spain had ≥10% decline across all condition ownership statements. France had ≥10% decrease in 4/5 proactive/preventative statements.

CONCLUSIONS: Access to the online asthma community may have encouraged patients to provide one another with support and additional resources, and to proactively seek information for improved health self-management elsewhere, resulting in high PAM levels in Italy, Germany and the USA. This indicates that access to additional information and support may be important for maintaining patient activation. Further support may be required for patients in Japan, Spain and France to facilitate proactive health self-management and education.