Background:
Health policy in the UK and elsewhere is prioritising patient empowerment and patientevaluations of healthcare. Patient reported outcome measures now take centre-stage inimplementing strategies to increase patient empowerment. This article argues forconsideration of patient empowerment itself as a directly measurable patient reportedoutcome for chronic conditions, highlights some issues in adopting this approach, andoutlines a research agenda to enable healthcare evaluation on the basis of patientempowerment.DiscussionPatient empowerment is not a well-defined construct. A range of condition-specific andgeneric patient empowerment questionnaires have been developed; each captures a differentconstruct e.g. personal control, self-efficacy/self-mastery, and each is informed by a differentimplicit or explicit theoretical framework. This makes it currently problematic to conductcomparative evaluations of healthcare services on the basis of patient empowerment. A casestudy (clinical genetics) is used to (1) illustrate that patient empowerment can be a valuedhealthcare outcome, even if patients do not obtain health status benefits, (2) provide arationale for conducting work necessary to tighten up the patient empowerment construct (3)provide an exemplar to inform design of interventions to increase patient empowerment inchronic disease. Such initiatives could be evaluated on the basis of measurable changes inpatient empowerment, if the construct were properly operationalised as a patient reportedoutcome measure. To facilitate this, research is needed to develop an appropriate and widelyapplicable generic theoretical framework of patient empowerment to inform (re)developmentof a generic measure. This research should include developing consensus between patients,clinicians and policymakers about the content and boundaries of the construct beforeoperationalisation. This article also considers a number of issues for society and forhealthcare providers raised by adopting the patient empowerment paradigm.SummaryHealthcare policy is driving the need to consider patient empowerment as a measurablepatient outcome from healthcare services. Research is needed to (1) tighten up the construct(2) develop consensus about what is important to include (3) (re)develop a generic measureof patient empowerment for use in evaluating healthcare (4) understand if/how people maketrade-offs between empowerment and gain in health status.