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Measuring Patient Activation as Part of Kidney Disease Policy: Are We There Yet?

Devika Nair and Kerri L. Cavanaugh
JASN July 2020, 31 (7) 1435-1443; DOI: https://doi.org/10.1681/ASN.2019121331
Devika Nair
1Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
2Vanderbilt O’Brien Center for Kidney Disease, Nashville, Tennessee
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Kerri L. Cavanaugh
1Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
2Vanderbilt O’Brien Center for Kidney Disease, Nashville, Tennessee
3Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee
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Abstract

Optimal care occurs when patients possess the skills, knowledge, and confidence needed to effectively manage their health. Promoting such patient activation in kidney disease care is increasingly being prioritized, and patient activation has recently emerged as central to kidney disease legislative policy in the United States. Two options of the Centers for Medicare and Medicaid Services Kidney Care Choices model—the Kidney Care First option and the Comprehensive Kidney Care Contracting option—now include patient activation as a quality metric; both models specifically name the patient activation measure (PAM) as the patient-reported outcome to use when assessing activation in kidney disease. Because nephrology practices participating in these models will receive capitated payments according to changes in patients’ PAM scores, it is time to more critically evaluate this measure as it applies to patients with kidney disease. In this review, we raise important issues related to the PAM’s applicability to kidney health, review and summarize existing literature that applies this measure to patients with kidney disease, and outline key elements to consider when implementing the PAM into practice and policy. Our aim is to spur further dialogue regarding how to assess and address patient activation in kidney disease to facilitate best practices for supporting patients in the successful management of their kidney health.

  • Patient self-assessment
  • kidney disease
  • outcomes
  • Copyright © 2020 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 31 (7)
Journal of the American Society of Nephrology
Vol. 31, Issue 7
July 2020
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Measuring Patient Activation as Part of Kidney Disease Policy: Are We There Yet?
Devika Nair, Kerri L. Cavanaugh
JASN Jul 2020, 31 (7) 1435-1443; DOI: 10.1681/ASN.2019121331

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Measuring Patient Activation as Part of Kidney Disease Policy: Are We There Yet?
Devika Nair, Kerri L. Cavanaugh
JASN Jul 2020, 31 (7) 1435-1443; DOI: 10.1681/ASN.2019121331
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  • Article
    • Abstract
    • Measuring and Interpreting Patient Activation
    • Evidence to Support Measuring Patient Activation in Kidney Disease
    • Remaining Knowledge Gaps and Challenges in Measuring Patient Activation
    • Lessons from the United Kingdom’s Efforts to Measure Patient Activation in Kidney Disease
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