A systematic review and meta-analysis of patient activation in people living with chronic conditions.


Cuevas H(1), Heitkemper E(2), Huang YC(3), Jang DE(2), García AA(2), Zuñiga JA(2).
Author information:
(1)The University of Texas at Austin, School of Nursing, USA. Electronic address: [Email]
(2)The University of Texas at Austin, School of Nursing, USA.
(3)Texas State University, St. David's School of Nursing, USA.


OBJECTIVE: The objectives of this review are to (1) describe the state of the science of patient activation interventions for the self-management of chronic conditions; (2) identify effective intervention elements for improving patient activation; and (3) compare intervention effectiveness across chronic conditions. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). PubMed, CINAHL, and Web of Science databases were searched. RESULTS: Thirty-two articles published between 2005 and 2019 were identified with intervention elements of self-management, disease management, and education. Meta-analysis of a subset of seven randomized controlled trials (n = 7) that used the 13-item version of the Patient Activation Measure with data collection points at 6 months demonstrated that patient activation did not change significantly in comparison with controls (MD = 0.25, 95 % CI = 0.02-0.47). CONCLUSION: Most interventions reported significant improvement in patient activation and were linked to tasks such as regular exercise and monitoring glucose. However, the meta-analysis of RCTs did not confirm these findings. PRACTICE IMPLICATIONS: Patient activation can be assessed and addressed uniformly across all chronic conditions to improve patient engagement in care.