News Release

Is “patient activation measure” relevant for adults on dialysis?

Measure assesses aspects of self-management of chronic conditions.

Peer-Reviewed Publication

American Society of Nephrology


  • The Patient Activation Measure describes an individual’s knowledge, ability, skills, and confidence in self-managing chronic conditions.
  • A recent study examined the measure’s relevance for patients with kidney failure who are undergoing long-term dialysis.

Washington, DC (September 1, 2021) — The Patient Activation Measure (PAM) is a standardized instrument that assesses an individual’s knowledge, ability, skills, and confidence in self-managing chronic medical conditions. A study published in JASN examined whether PAM is a meaningful metric for adults with kidney failure who are on long-term dialysis. These patients are actively involved in multiple domains of their care, such as keeping track of frequent treatments, following specified diets, and taking multiple medications.

The study included 175 patients being treated with in-center hemodialysis between August 2020 and January 2021 at 3 sites (2 in New York City and 1 in Seattle). There was no significant relationship between PAM scores and missed dialysis sessions or weight gain between dialysis sessions. Investigators found a strong relationship between lower PAM scores and lower levels of health literacy and higher levels of depression and anxiety, however.

“Living with kidney failure is difficult and requires a lot of effort to keep up with all of the necessary treatments, doctor’s visits, and medications. Finding ways of supporting motivated patients and helping to develop strategies to engage others is essential for the patients’ overall health,” said lead author Daniel Cukor, PhD, of The Rogosin Institute, in New York. “The extent to which the PAM describes a patient with kidney failure’s level of engagement is unclear, as the measurement may be picking up on other issues known to interfere with engaged care, such as low health literacy and high levels of depression or anxiety, which are very common comorbidities in this population. The fact that the PAM was highly associated with these known variables, but not measures of dialysis attendance or dietary compliance, raises questions about its utility.”

Study co-authors include Leila Zelnick, PhD, David Charytan, MD, MSc, Amanda Shallcross, ND, MPH, and Rajnish Mehrotra, MD, MA.

Disclosures: Rajnish Mehrotra has received honorarium from Baxter Healthcare. David Charytan has received personal fees from Fresenius.

The article, titled “Patient Activation Measure in Dialysis Dependent Patients in the United States,” will appear online at on September 1, 2021.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the authors. ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 21,000 members representing 131 countries. For more information, visit


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