Kinney Rebecca L, Lemon Stephenie C, Person Sharina D, Pagoto Sherry L, Saczynski Jane S
Department of Quantitative Health Sciences, University of Massachusetts, Medical School, Worcester, USA.
Department of Medicine, University of Massachusetts, Medical School, Worcester, USA.
Patient Educ Couns. 2015 May;98(5):545-52. doi: 10.1016/j.pec.2015.02.005. Epub 2015 Feb 19.
A systematic review of the published literature on the association between the PAM (Patient Activation Measure) and hospitalization, emergency room use, and medication adherence among chronically ill patient populations.
A literature search of several electronic databases was performed. Studies published between January 1, 2004 and June 30, 2014 that used the PAM measure and examined at least one of the outcomes of interest among a chronically ill study population were identified and systematically assessed.
Ten studies met the eligibility criteria. Patients who scored in the lower PAM stages (Stages 1 and 2) were more likely to have been hospitalized. Patients who scored in the lowest stage were also more likely to utilize the emergency room. The relationship between PAM stage and medication adherence was inconclusive in this review.
Chronically ill patients reporting low stages of patient activation are at an increased risk for hospitalization and ER utilization.
Future research is needed to further understand the relationship between patient activation and medication adherence, hospitalization and/or ER utilization in specific chronically ill (e.g. diabetic, asthmatic) populations. Research should also consider the role of patient activation in the development of effective interventions which seek to address the outcomes of interest.
对已发表文献进行系统综述，探讨患者激活量表（PAM）与慢性病患者群体的住院治疗、急诊室就诊及药物依从性之间的关联。
对多个电子数据库进行文献检索。确定并系统评估2004年1月1日至2014年6月30日期间发表的、使用PAM量表并在慢性病研究人群中考察至少一项感兴趣结局的研究。
十项研究符合纳入标准。PAM量表得分处于较低阶段（1期和2期）的患者更有可能住院。处于最低阶段的患者也更有可能使用急诊室。本综述中，PAM阶段与药物依从性之间的关系尚无定论。
报告患者激活水平较低阶段的慢性病患者住院和使用急诊室的风险增加。
未来需要进一步研究，以深入了解患者激活与特定慢性病（如糖尿病、哮喘）人群的药物依从性、住院治疗和/或急诊室就诊之间的关系。研究还应考虑患者激活在制定旨在解决感兴趣结局的有效干预措施中的作用。
