FRI0612 How effective are interventions targeting patient activation in people with long term physical conditions? a systematic review
Authors: B. Jones, S. Hewlett, D. Harcourt, A. Hunt, E. Dures
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Patient activation is an increasingly referenced concept in the self management of long term physical conditions. It refers to someone's ability to take an active role in self-managing their health. There has been a substantial increase in the number of studies trailing interventions targeting patient activation in a variety of formats. The findings from this review will contribute to maximising the impact of current rheumatology interventions, and to increase the understanding of patient activation to develop a framework to describe its core components within a rheumatology context. <h3>Objectives:</h3> This study aimed to identify the effectiveness of interventions targeting patient activation in people with long-term conditions, including rheumatoid arthritis. <h3>Methods:</h3> Studies that were randomised control trials of interventions targeting patient activation in adults with long term physical conditions were included in the review. PsycINFO, Medline, AMED, CINAHL, and ProQuest were searched during January 2017, as well as a variety of grey literature locations, snowballing and hand-searching to identify potential studies for inclusion. The Cochrane Collaboration's Risk of Bias Tool was used to determine the methodological quality of included studies, and any differences were resolved by the two reviewers. Authors were contacted if any additional information was required to extract data or to clarify risk of bias. <h3>Results:</h3> 17 papers were included in the review. There was a great deal of heterogeneity in the types of interventions available targeting patient activation in a variety of populations, and a meta-analysis was not possible as a result. Interventions were delivered via face to face, telephone, internet and resource-based approaches. The studies also included a mix of group and individually delivered interventions. Outcome measures used also varied, including both direct and proxy measures for patient activation. The findings suggest that in studies with interventions that are more structured, there appear to be a trend towards differences in patient activation scores between groups in favour of the intervention. It is possible that these increases in patient activation may occur with an increase in health literacy, as the literature suggests an association between the two constructs. This is discussed in terms of a proposed model for patient activation for rheumatology. <h3>Conclusions:</h3> There is some initial evidence for the benefit of increasing structure in interventions targeting patient activation. There is no evidence for a medium of delivery that is most effective in people with long term conditions. Studies would benefit from reporting information about engagement and adherence to interventions to understand the mechanisms behind engaged participants becoming more active in managing their health. There is a need for increased research into patient activation within Rheumatology. <h3>Disclosure of Interest:</h3> None declared