‘Patient activation’ is a widely recognised concept. It describes the knowledge, skills and confidence a person has in managing their own health and health care. Patient activation scores are closely linked to clinical outcomes, the costs of health care and patients’ ratings of their experience. Furthermore, studies show that age, education, income and gender account for only 5 to 6 per cent of the variation in patient activation. Most importantly, patient activation is a much better predictor of health outcomes than known socio-demographic factors such as ethnicity and age. These findings appear to be true for patients with a range of different conditions and economic backgrounds, including disadvantaged and ethnically diverse groups and those who have less access to care. One study following disadvantaged diabetes patients over a six-month period found that more-activated patients were more likely to perform foot checks, obtain eye examinations and exercise regularly than less-activated patients.
Launch of the Community Pharmacy Patient Activation Project
In December 2016 Cornwall & Isles of Scilly Local Pharmaceutical Committee (LPC) and the South West Cardiovascular Clinical Network launched a developmental service in 20 community pharmacies across Cornwall. The project is one of the first in England in which community pharmacists will be using the Patient Activation Measure (PAM) & motivational interviewing to improve patient activation and self-management of type 2 diabetes (T2DM).
‘Patient activation’ describes the knowledge, skills and confidence a person has in managing their own health and health care. Patient activation scores are closely linked to clinical outcomes, the costs of health care and patients’ ratings of their experience so any increase in activation level has been shown to translate to better healthcare outcomes.
Claire Field, Community Pharmacist based in Carbis Bay is heading up the project and held the initial project briefing at Kingsley Village, Fraddon in November. There were presentations by Diabetes Nurse & Dietitian Specialists and representatives from NHS Kernow as well as Health Promotion Cornwall who talked about the skill and benefits of motivational interviewing.
It is a priority for the NHS to enable patients to take the lead role in their own healthcare and supporting self-care is a key feature of NHS England’s Five Year Forward View in making the best use of NHS resources and patient activation may be a key tool in making this happen.
Each of the Pharmacies involved will recruit 25 patients to the project and the pharmacists will be supporting their patients to set achievable goals that will improve their diabetes care and follow them up closely over a three month period.
Research shows that when people become more activated they are more likely to change their behaviors. Therefore encouraging small steps to achieve simple goals builds on motivation and confidence for making other, perhaps bigger and more clinically meaningful steps in the future and we are very excited to see how this project will help patients with type 2 diabetes in Cornwall improve their long-term health.