Patient engagement is a vague concept in healthcare that is in danger of becoming merely a “hot buzz phrase,” according to a new study.

"Although the concept of patient engagement promises to deliver significant value for healthcare providers, patients, and other healthcare stakeholders, many gaps still exist for patient engagement to make an impact on the Western healthcare systems at large," conclude researchers at the Catholic University of the Sacred Heart in Milan, Italy, in a study published in the Journal of Participatory Medicine. "That is why the healthcare field could benefit from an evidence-based analysis of the term ‘patient engagement.’"

To ascertain the shifting meaning of the term over the past decade, the authors searched five electronic databases from 2002 to 2013 with no language restrictions (MEDLINE, PsychINFO, CINAHL, Web of Science, and SCOPUS). A qualitative software-based thematic analysis was performed on papers dealing with the concept of patient engagement retrieved by a systematic review of the literature. Searches yielded 1,020 articles, of which 259 studies fulfilled the inclusion criteria.

The authors said conceptualization of patient engagement is still vague and has changed over time, thus offering a fragmented and partial vision of this phenomenon: "The current literature focuses alternatively on different and singular aspects of the patient engagement phenomenon while missing the whole picture of the elements that may hinder or facilitate patient engagement." 

In order to better understand and implement a patient engagement strategy, they said, clinicians will need to recognize that patients go through a multi-phase experience when experiencing a challenging period in their health.

A more comprehensive modeling of patient engagement, they said, should take into account the roles, features, and evolving characteristics in time of all the pivotal elements in the process, such as the engagers (health care professionals, organizations, and communities), the engagees (patients and their caregivers) and of engaging elements such as devices, interventions, and tools.

Such a perspective towards engagement may help policy makers in setting research and funding agendas that can really improve the quality, relevance, ethical dimensions and implementation of the research conducted and ensure that research resources address the issues which are most important to patients affected by healthcare problems, they said.

"Furthermore, this approach can help in drafting guidelines for planning interventions able to foster patient engagement in a way that is really fine-tuned with the specific phase of the patient’s experience. It may contribute to understanding the real value of patients being involved in the care process according to a patient-centered approach."

The study is available here.

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