The Rise of Patient Activation and Shared Decision-Making: Redefining the Future of Healthcare

  • Raja D Professor, Department of Community Medicine, Chettinad Hospital & Research Institute, Chettinad Academy of Research & Education, Kelambakkam, Chengalpattu district, Tamil Nadu, India

Abstract

Healthcare has undergone a remarkable transformation over the past few decades. Traditionally, healthcare delivery followed a paternalistic model in which doctors made decisions on behalf of patients, assuming
that medical expertise alone was sufficient to determine the best course of treatment. While this approach undoubtedly contributed to many advances in medicine, it often overlooked an equally important
component of healthcare - the patient’s values, preferences, and lived experiences. Today, this scenario is changing rapidly with the emergence of patient activation and shared decision-making [SDM], two
complementary concepts that place patients at the center of healthcare. Together, they represent a shift from “doing things to patients” toward“working with patients” to achieve better health outcomes.

References

Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure [PAM]: conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39[4 Pt 1]:1005–26.

Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27[10]:1361–7.

Greene J, Hibbard JH. Why does patient activation matter? An examination of the relationships between

patient activation and health-related outcomes. J Gen Intern Med. 2012;27[5]:520–6.

Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care

experiences; fewer data on costs. Health Aff [Millwood]. 2013;32[2]:207–14.

Barry MJ, Edgman-Levitan S. Shared decision making—The pinnacle of patient-centered care. N Engl J Med.

;366[9]:780–1.

Shay LA, Lafata JE. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Making. 2015;35[1]:114–31.

World Health Organization. Global strategy on digital health 2020–2025. Geneva: World Health Organization;

Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes:

an updated systematic review. Ann Intern Med. 2011;155[2]:97–107.

Légaré F, Ratté S, Gravel K, Graham ID. Barriers and facilitators to implementing shared decision-making

in clinical practice: update of a systematic review of health professionals’ perceptions. Patient Educ Couns.

;73[3]:526–35.

Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, et al. Decision aids for people facing health

treatment or screening decisions. Cochrane Database Syst Rev. 2017;4[4]:CD001431.

Published
2026-07-14