# Improving Clinical Patient Activation and Strengthening Health Outcomes: Findings from a Quasi-Experimental Study

## TL;DR

This study tested how using the Patient Activation Measure (PAM-13) in a Saudi healthcare center affects patient engagement and health outcomes.

## Contribution

The study evaluates the feasibility and impact of PAM-13 in a Saudi tertiary healthcare setting for the first time.

## Key findings

- Baseline PAM-13 scores showed most patients were in activation levels 2 and 3.
- Tailored interventions significantly improved activation in the intervention group (p = 0.004), especially for those with lower initial scores.
- Control group activation scores declined, and no immediate clinical improvements were observed.

## Abstract

Background/Objectives: The complexity of healthcare systems and the unclear interactions within them remain key challenges to improving quality and outcomes. The Patient Activation Measure (PAM-13) is a tool that offers insight into patient interactions with healthcare services and has been used for nearly 20 years. However, its application in tertiary healthcare facilities in Saudi Arabia has not been evaluated. This study aimed to assess the feasibility and acceptability of implementing the PAM-13 in a university Family Medicine Center and to evaluate its effect on enhancing patients’ engagement, activation, self-management, and participation in routine care. Methods: A quasi-experimental study was conducted from November 2024 to June 2025 using stratified cluster sampling from the diabetes and chronic diseases unit, care of older adults’ unit, and general family medicine unit. The estimated sample size was 65 patients. Statistical analyses were performed using SPSS. Results: Baseline PAM-13 scores varied across participants, with most patients in levels 2 and 3. Following the tailored intervention, activation significantly improved in the intervention group (p = 0.004), particularly among those initially in levels 1 and 2. Activation scores in the control group declined. No significant short-term changes were observed in clinical outcomes, including blood pressure, glucose, or cholesterol levels. Conclusions: Tailored interventions based on PAM-13 enhanced patient activation in a tertiary care setting. Patients with lower baseline activation showed notable improvements in engagement and self-management. Further longitudinal, multicenter studies are needed to determine the sustainability and clinical impact of these improvements.