Patient-reported outcome measures for monitoring primary care patients with depression: PROMDEP feasibility randomised trial

Background and objectives: The use of appropriate outcome measures can help guide multidimensional low back pain (LBP) management, elucidate the efficacy/effectiveness of interventions, and inform clinicians when selected targets have been achieved and this can be used for educational or research purposes. Aim: This study aimed to explore and describe the use, attitudes, knowledge, and beliefs regarding patient-reported outcome measures used by healthcare practitioners practising in Saudi Arabia who are frequently involved in the healthcare of individuals with LBP. Materials and Methods: A cross-sectional design was undertaken using a web-based survey. An electronic invitation to participate was sent to primary care physicians and physical therapists practising in Saudi Arabia. The survey included three sections: demographic data, a list of the most commonly used patient-reported outcome measures with LBP patients, and statements regarding attitudes, knowledge, and beliefs about outcome measures. Results: A total of 156 practitioners participated: 45 primary care physicians and 111 physical therapists. The numeric pain rating and visual analogue scales were the outcome measures most frequently reported as being often used by both primary care physicians and physical therapists. The majority of participants reported often using 1–2 patient reported outcome measures (PROMs). While most participants indicated that they were confident at selecting the most appropriate PROM, fewer were familiar with the concept of the minimally important clinical difference. A lack of Arabic versions of PROMs was reported as a barrier to using them to assess pain. Conclusions: This study shows that, although primary care physicians and physical therapists in Saudi Arabia frequently use patient-reported outcome measures in their clinical management of patients with LBP, there is a noticeable gap in the knowledge and use of the multidimensional outcome measures for LBP management among the participants. This highlights a need for professional training on the use of standardised outcome measures related to LBP.

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Exploring the perspective of patients with musculoskeletal health problems in primary care on the use of patient-reported outcome measures to stimulate quality improvement in physiotherapist practice; a qualitative study.

Physiotherapy Theory and Practice ◽

10.1080/09593985.2019.1678205 ◽

2019 ◽

pp. 1-12

Author(s):

Guus A. Meerhoff ◽

Simone A. van Dulmen ◽

Marjo J.M. Maas ◽

Annick Bakker-Jacobs ◽

Maria W.G. Nijhuis-Van der Sanden ◽

...

Keyword(s):

Primary Care ◽

Quality Improvement ◽

Qualitative Study ◽

Outcome Measures ◽

Patient Reported Outcome Measures ◽

Health Problems ◽

Patient Reported Outcome ◽

Musculoskeletal Health ◽

Patient Reported

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The routine collection of patient-reported outcome measures (PROMs) for long-term conditions in primary care: a cohort survey

BMJ Open ◽

10.1136/bmjopen-2013-003968 ◽

2014 ◽

Vol 4 (2) ◽

pp. e003968 ◽

Cited By ~ 40

Author(s):

Michele Peters ◽

Helen Crocker ◽

Crispin Jenkinson ◽

Helen Doll ◽

Ray Fitzpatrick

Keyword(s):

Primary Care ◽

Outcome Measures ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Long Term Conditions ◽

Patient Reported

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Integrating Patient Reported Outcome Measures (PROMs) into routine nurse-led primary care for patients with multimorbidity: a feasibility and acceptability study

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01748-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Ian Porter ◽

Antoinette Davey ◽

Jaheeda Gangannagaripalli ◽

Jonathan Evans ◽

Charlotte Bramwell ◽

...

Keyword(s):

Primary Care ◽

Outcome Measures ◽

Thematic Analysis ◽

Qualitative Interviews ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Convenience Sample ◽

Patient Reported ◽

Primary Care Practices ◽

High Degree

Abstract Background The use of Patient Reported Outcome Measures (PROMS) in clinical practice has the potential to promote patient-centred care and improve patients’ quality of life. Individualized PROMs may be particularly helpful in identifying, prioritizing and monitoring health problems of patients with multimorbidity. We aimed to develop an intervention centred around PROMs feedback as part of Primary Care annual reviews for patients with multimorbidity and evaluate its feasibility and acceptability. Methods We developed a nurse-oriented intervention including (a) training of nurses on PROMs; (b) administration to patients with multimorbidity of individualized and standardized PROMS; and (c) feedback to both patients and nurses of PROMs scores and interpretation guidance. We then tailored the intervention to patients with two or more highly prevalent conditions (asthma, COPD, diabetes, heart failure, depression, and hip/knee osteoarthritis) and designed a non-controlled feasibility and acceptability evaluation in a convenience sample of primary care practices (5). PROMs were administered and scores fed back immediately ahead of scheduled annual reviews with nurses. Patients and nurses rated the acceptability of the intervention using with a brief survey including optional free comments. Thematic analysis of qualitative interviews with a sample of participating patients (10) and nurses (4) and of survey free comments was conducted for further in-depth evaluation of acceptability. Feasibility was estimated based on rates of participation and completion. Results Out of 68 recruited patients (mean age 70; 47% female), 68 completed the PROMs (100%), received feedback (100%) and confirmed nurse awareness of their scores (100%). Most patients (83%) “agreed”/”strongly agreed” that the PROMs feedback had been useful, a view supported by nurses in 89% of reviews. Thematic analysis of rich qualitative data on PROMS administration, feedback and role in annual reviews indicated that both patients and nurses perceived the intervention as acceptable and promising, emphasizing its comprehensiveness and patient-centredness. Conclusions We have developed and tested an intervention focusing on routine PROM assessment of patients with multimorbidity in Primary Care. Preliminary findings support its feasibility and a high degree of acceptability from both patients and nurses. The next step is to conduct a full-scale trial for evaluating the effectiveness of the proposed intervention.

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Patient reported outcome measures (PROMs) for goalsetting and outcome measurement in primary care physiotherapy, an explorative field study

Physiotherapy ◽

10.1016/j.physio.2016.01.001 ◽

2017 ◽

Vol 103 (1) ◽

pp. 66-72 ◽

Cited By ~ 10

Author(s):

Simone A. van Dulmen ◽

Philip J. van der Wees ◽

J. Bart Staal ◽

J.C.C. Braspenning ◽

Maria W.G. Nijhuis-van der Sanden

Keyword(s):

Primary Care ◽

Field Study ◽

Outcome Measures ◽

Outcome Measurement ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Patient Reported

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Comparing sensitivity to change of two patient-reported outcome measures in a randomised trial of patients referred for physiotherapy services

Trials ◽

10.1186/1745-6215-14-s1-o50 ◽

2013 ◽

Vol 14 (Suppl 1) ◽

pp. O50 ◽

Cited By ~ 2

Author(s):

Selman Mirza ◽

Chris Salisbury ◽

Cherida Hopper ◽

Nadine Foster ◽

Alan Montgomery

Keyword(s):

Outcome Measures ◽

Randomised Trial ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Sensitivity To Change ◽

Patient Reported

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General practitioners’ views on use of patient reported outcome measures in primary care: a cross-sectional survey and qualitative study

10.21203/rs.2.13219/v1 ◽

2019 ◽

Author(s):

Grace M Turner ◽

Ian Litchfield ◽

Sam Finnikin ◽

Olalekan Lee Aiyegbusi ◽

Melanie Calvert

Keyword(s):

Primary Care ◽

General Practitioners ◽

Outcome Measures ◽

Qualitative Interviews ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Patient Reported ◽

Clinical Systems

Abstract Background Patient reported outcome measures (PROMs) are increasingly used to assess impact of disease and treatment on quality of life and symptoms; however, their use in primary care is fragmented. We aimed to understand the current use of PROMs in primary care, barriers and facilitators, and how their use might be optimised. Methods Cross-sectional survey and semi-structured interviews among general practitioners (GPs) in England. GPs’ opinions were explored using an electronic, self-completed questionnaire disseminated to 100 GPs via an online doctors’ community and semi-structured qualitative interviews with 25 GPs. Results Most GPs surveyed (77/100; 77%) reported using one or more PROM, primarily to aid clinical management (n=66) or as screening/diagnostic tools (n=62). Qualitative interviews highlighted challenges in identifying and selecting PROMs; however, some GPs valued PROMs for shared decision making and to direct patient discussions. The interviews identified key barriers to PROM use including: time constraints; insufficient knowledge; lack of integration into clinical systems; and PROMs being mandated without consultation or explanation. Evidence of the benefit of PROMs is required to promote uptake and use of PROMs in primary care. Conclusion Implementation of PROMs in primary care requires integration with clinical systems, a bottom-up approach to PROM selection and system design involving meaningful consultation with patients and primary care clinicians and training/support for use.

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