Optimising PSPs: Tapping into patient activation to help patients achieve their goals

Written by Laura Galimam

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Developing adequate Patient Support Programmes for patients on a particular treatment is often a key value-added service of additional interest for many pharma companies.

But when researching and developing what types of programs could be of benefit, are we taking into account how patients would engage with these programs?

Patients vary in their health-related behaviours, particularly when it comes to self-management of chronic conditions such as asthma1, diabetes2 and even cancer3.

It is no surprise then to hear from some patients that some current support programs are ‘not fit for purpose’ as they feel that they lack the specificity to make it relatable to them as an individual.

So how can a healthcare system and pharmaceutical company support a patient in the best way possible, to engage them in their health and treatment?

One solution that many CCGs in the UK NHS have adopted, is looking at how the Patient Activation Measure model or (PAM) can be incorporated into the way that HCPs are managing patients, particularly those with chronic conditions.4

A growing body of evidence indicates that enabling people to feel they can take control of their own health, can lead to good behaviour change, and ultimately a greater sense of well-being and better health outcomes.5

So as the name suggests, the purpose of PAM is to enable the delivery of personalised care that supports people in developing their own skills and capabilities to manage their own health (activation).

What can any healthcare system or pharmaceutical company looking to develop a patient support program, learn from PAM?

It is no secret that patients are all unique, but it would be beyond the financial scope of any system or company to create a truly tailored approach.

The key therefore is rather to provide the tools and information that would allow sets of different patients who operate at different levels of capabilities, to feel like they are able to take control of their health back.

PAM suggests that patients fall into 4 broad categories of ‘activation’ – different levels that reflect their attitudes and abilities to make appropriate behavioural choices.

For example some patients find it easy to change behaviour that may lead to a desired goal (Level 4), whereas for others the task may seem like a mammoth challenge and they may not know even where to start (Level 1).

The key to the ideal support therefore lies in designing programs which are able to provide or advise on appropriate actions that are aligned with an individual’s own perceived capabilities.

By providing something that is appropriate for an individual’s level, you are thereby giving them a better chance at being successful at this action or goal.

For example, patients with obesity that have low confidence or are passive in their self-care, may find a strategy by which they are able to make baby steps in their lifestyle that can help them reduce their BMI, greatly reducing their risk of developing co-morbidities. The task of losing for example 6 stone, is no longer too vast or too complicated for them to tackle but the implications are life-changing.

So when designing patient support programs, let’s take into consideration the challenges that different groups of patients face, by providing them the right tools at the right level for them.

Then and only then will pharmaceutical companies be able to make a significant impact on patients’ lives, with Patient Support Programmes that actually make a difference.

1 Mosen, DM. et al. (2007). Is patient activation associated with outcomes of care for adults with chronic conditions? Journal of Ambulatory Care Management. 30(1), 21-29.
2 Sacks, RM. et al. (2017). Does patient activation predict the course of type 2 diabetes? A longitudinal study. Patient Education and Counselling. 100(7), 1268-1275.
3 Hibbard, JH. et al. (2017). Does patient activation level affect the cancer patient journey? Patient Education and Counselling. 100(7), 1276-1279.
4 NHS England – Patient Activation; https://www.england.nhs.uk/ourwork/patient-participation/self-care/patient-activation/
5 Greene, J. et al. (2015). When Patient Activation Levels Change, Health Outcomes And Costs Change, Too. Health Affairs, 34(3) https://doi.org/10.1377/hlthaff.2014.0452

This article was written by Laura Galimam who sits on The Patient Centre team at Cello Health Insight.

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