TY - JOUR
T1 - Does patient activation matter?
T2 - An examination of the relationships between patient activation and healthcare use in older adults with mild frailty after discharge from an emergency department
AU - Harper, Kristie
AU - Williamson, Melinda
AU - Arendts, Glenn
AU - Edwards, Deborah
AU - Buller, Bridgette
AU - Haak, Jenna
AU - Jacques, Angela
AU - Barton, Annette
AU - Petta, Antonio
AU - Celenza, Antonio
PY - 2024/8/26
Y1 - 2024/8/26
N2 - Objective Patient engagement, as measured by the Patient Activation Measure (PAM (R)), has been used to assess patients' ability to manage their own care. This study aimed to determine whether the PAM (R) could predict healthcare use in older adults aged >70 years, living independently in the community with mild frailty, within 30 days after emergency department (ED) discharge. Methods A prospective single-centre observational cohort study was completed including older adults who presented to an ED. The 13-item PAM (R) and selected International Consortium for Health Outcomes Measures were completed prior to ED discharge. Results Two hundred patients were recruited with a mean age of 84.8 years (s.d. 6.9). The mean PAM (R) score was 58.6 (s.d. 13.3), with 12.5% at Level 1 (n = 25), 40% at Level 2 (n = 80), 34.5% at Level 3 (n = 69) and 13.0% at Level 4 (n = 26). The PAM (R) level was significantly associated with ED presentations in the past 6 months (P = 0.030). The PAM (R) level did not predict healthcare use within 30 days of discharge consisting of time until ED representation (P = 0.557), number of ED representations (P = 0.560), number of hospital admissions (P = 0.499), length of stay in hospital (P = 0.254) and number of post-discharge contacts (P = 0.667). Conclusions Overall, the PAM (R) did not predict prospective short-term healthcare use. However, the PAM (R) was significantly associated with 6-month previous ED use. With more than 50% of patients at Level 1 or 2, indicating lower capacity for self-management, tailored interventions are required to assist mildly frail patients to manage discharge care plans and engage in preventative strategies.
AB - Objective Patient engagement, as measured by the Patient Activation Measure (PAM (R)), has been used to assess patients' ability to manage their own care. This study aimed to determine whether the PAM (R) could predict healthcare use in older adults aged >70 years, living independently in the community with mild frailty, within 30 days after emergency department (ED) discharge. Methods A prospective single-centre observational cohort study was completed including older adults who presented to an ED. The 13-item PAM (R) and selected International Consortium for Health Outcomes Measures were completed prior to ED discharge. Results Two hundred patients were recruited with a mean age of 84.8 years (s.d. 6.9). The mean PAM (R) score was 58.6 (s.d. 13.3), with 12.5% at Level 1 (n = 25), 40% at Level 2 (n = 80), 34.5% at Level 3 (n = 69) and 13.0% at Level 4 (n = 26). The PAM (R) level was significantly associated with ED presentations in the past 6 months (P = 0.030). The PAM (R) level did not predict healthcare use within 30 days of discharge consisting of time until ED representation (P = 0.557), number of ED representations (P = 0.560), number of hospital admissions (P = 0.499), length of stay in hospital (P = 0.254) and number of post-discharge contacts (P = 0.667). Conclusions Overall, the PAM (R) did not predict prospective short-term healthcare use. However, the PAM (R) was significantly associated with 6-month previous ED use. With more than 50% of patients at Level 1 or 2, indicating lower capacity for self-management, tailored interventions are required to assist mildly frail patients to manage discharge care plans and engage in preventative strategies.
KW - Aftercare
KW - Aged
KW - Emergency department
KW - Frailty
KW - Hospitals
KW - Patient activation
KW - Patient discharge
KW - Self-management
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=uwapure5-25&SrcAuth=WosAPI&KeyUT=WOS:001311239100001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1071/AH24033
DO - 10.1071/AH24033
M3 - Article
C2 - 39183070
SN - 1743-8462
VL - 49
JO - Australian Health Review
JF - Australian Health Review
M1 - AH24033
ER -