SynthesisBMJ open2025
Association between patient activation, self-management behaviours and clinical outcomes in adults with type 2 diabetes: a systematic review with narrative synthesis.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
5 citing papers in PubMed.
- Breaking the cycle: patient activation role in improving diabetes self-care adherence for alleviating diabetes distress.The Libyan journal of medicine · 2026Article
- Patient Activation and Diabetes Outcomes Among Jordanian Patients With Type 2 Diabetes: Longitudinal Evidence on Adherence and Glycemic Control With Linear Mixed Model Analysis.Research in nursing & health · 2026Article
- Patient Activation After New Diabetes Diagnosis: Interpreting Early Adaptation in Diabetes Care.Research in nursing & health · 2026Article
- Relationship between patient activation, experienced stigma, and internalised weight stigma in people with type 2 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2026Observational
- The Mediating Role of Patient Activation in the Association Between Illness Perception and Self-Management Behavior Among Patients with Oral Cancer.Patient preference and adherence · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPatient activation (PAct)-a measure assessing an individual's perceived knowledge, skills and confidence in managing their health and well-being-is often used to personalise and evaluate care, although its causal link to self-management behaviours (SMBs) and clinical outcomes remains uncertain. We aimed to synthesise the evidence on the causal association between PAct, SMBs and clinical outcomes in type 2 diabetes (T2D).
designSystematic review and narrative synthesis of data summarised in a harvest plot. DATA SOURCES: We searched Medline, Embase, CENTRAL, PsycInfo, Web of Science and CINAHL up to April 2024 for relevant English articles. ELIGIBILITY CRITERIA: We included studies of any quantitative design that reported on the association of PAct with clinical outcomes or SMBs in adult patients with T2D. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers were involved, and any disagreements were discussed and resolved collaboratively. Risk-of-bias (RoB) was assessed using an adapted RoB Assessment Tool for Nonrandomised Studies. Levels of evidence were evaluated for each T2D-related outcome.
resultsWe identified 21 studies published between 2009 and 2023, including 15 cross-sectional studies and no randomised controlled trials. Eleven studies were conducted in the USA. Seventeen studies used the Patient Activation Measure questionnaire. There is moderate evidence that higher PAct scores are associated with better glycated haemoglobin levels (studies reporting on this association, n=14). There is very limited evidence that PAct improves diet (n=5) and physical activity (n=6). All other clinical outcomes and SMBs had inconclusive results due to either inconsistent or insufficient evidence, or both.
conclusionA causal relationship between PAct, clinical outcomes and SMBs in T2D cannot be established due to inconsistent evidence and a lack of high-quality studies. Thus, the use of PAct scores as a tailoring tool and an outcome measure in healthcare services requires further evaluation. PROSPERO REGISTRATION NUMBER: CRD42021230727.
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