OBJECTIVES: The aim was to examine the relationship between levels of patient activation (knowledge, skill, and confidence in health management) and health outcomes across multiple conditions.

METHODS: Data from the 2017 EU5 (n=62,000; France, Germany, Italy, Spain, and UK) Kantar Health PaCeR (patient-centered research) platform was used. Adults were surveyed using stratified random sampling based on gender and age to ensure representativeness to the general population. Patients self-reported a physician diagnosis of depression, type 2 diabetes (T2D), chronic pain, or psoriasis. The Patient Activation Measure^® or PAM^® consists of four levels. Level 1 or “disengaged and overwhelmed” indicates lowest patient activation while level 4 or “maintaining behaviors and pushing further” indicates highest activation. Outcomes included healthcare provider (HCP) visits, health-related quality of life (HRQoL; SF-12v2mental component summary [MCS] and physical component summary [PCS] scores), and work and activity impairment RESULTS: Across all conditions, higher patient activation was associated with a greater percentage of patients with HCP visits, improved HRQoL, and less activity impairment. The percent of patients with HCP visits increased as patient activation increased ranging from 90.3% to 99.3%. Higher levels of patient activation corresponded to better health. Across all conditions, there was a clinically meaningful difference in MCS which ranged from 4.27 (level 1) to 8.04 (level 4). T2D patients at the highest activation level had the highest MCS (50.27), whereas patients with depression had the lowest MCS (38.09). PCS scores across all conditions and activation levels were lower than the general population. Higher patient activation scores were associated with less activity impairment and this was most pronounced for patients with depression (54.6% vs. 45.7%, p < 0.05) or T2D (45.3% vs. 31.0%, p < 0.05).

CONCLUSIONS: Understanding where patients fall on the activation continuum can inform communications to increase patients’ activation and improve health outcomes.