scholarly journals THE USE OF PATIENT REPORTED OUTCOME MEASURES BY PHYSICAL THERAPISTS IN THE PEDIATRIC SPORTS POPULATION

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0003
Author(s):  
Jamila N. Aberdeen ◽  
Heather F. Stewart ◽  
Rebecca K. Frank Burnett ◽  
Elliot Greenberg
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Outcome Measures ◽  
Response Rate ◽  
Physical Therapists ◽  
Clinical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
Knee Disorders

Purpose: Patient reported outcome measures (PROs) allow physical therapists (PTs) the ability to objectively understand a patients’ perception of their symptoms, functional status, and health related quality of life. Although professional organizations have issued recommendations for PRO use, many of these measures were developed and validated within the adult population which may limit their application to pediatric orthopedics. It is currently unknown which measures are being used within this population, and thus the purpose of this study is to evaluate the current use of PROs among pediatric sports PT and determine how PRO information is used in clinical care. Methods: An online survey, developed in REDCap™, was administered via email to members of the Sports Section Youth Athlete Special Interest Group (YASIG) and the Pediatric Research in Sports Medicine Society (PRiSM), over the course of 8 weeks. The survey was developed and pilot tested by 4 physical therapists and 3 orthopedic surgeons and consisted of 24 possible questions, taking 3-5 minutes to complete. Descriptive statistics and frequency tallies were utilized to analyze the data. Results: There was a total of 70 respondents (response rate YASIG 17%; response rate PRiSM 90%) who completed the questionnaire in its entirety. There was a wide range of clinical experience with 31% reporting 0-5 years, 23%, 6-10 years, 16%, 11-15 years, and 30% >16 years. The majority (54%) reported working in a hospital based outpatient setting or private practice (24%). Ninety four percent (n=66) of respondents reported using PROs, with 100% (n=66) of these subjects issuing them at the initial visit, 94% (n=62) at discharge, and 91% (n=60) monthly. The Neck Disability Index (76%, n=50), Oswestry (76%, n=50), and QuickDASH (68%, n=45) were most frequently used for neck, back and shoulder disorders, respectively. The Lower Extremity Functional Scale (LEFS) was the most widely utilized measure for multiple body regions including 74% (n=49) for either hip or knee dysfunction, and 26% (n=16) for ankle. In general, knee disorders demonstrated the highest degree of variability in scale selection with 52% (n=34) using the IKDC, 35% (n=23) using the Pedi-IKDC and 20% (n=13) (using the KOOS). The information obtained from PROs was used to demonstrate effectiveness of treatment (80%, n=53), inform clinical decisions (77%, n=51), satisfy insurance requirements (59%, n=39), used for goal writing (60%, n=40), and research (36%, n=24). Only 6% (n=4) of PTs indicated that PROs did not impact clinical reasoning within their plan of care. When asked how the information from PROs is used within clinical practice, it was noted that 71% (n=47) of PTs would ‘revise physical therapy goals’ if scores were either higher or lower than expected and 38% (n=25) would ‘refer patient back to the physician’ if PRO results showed lack of progress or regression. In addition, 20% (n=13) of PTs noted they utilize the results from PROs to help inform discharge decision making. When asked regarding barriers to using PROs, PTs reported inadequate time (42%, n=28), difficultly remembering to administer (38%, n=25) and uncertainty regarding which PRO to use (21%, n=14) as the main impediments in using PROs. Conclusions: Our results indicate that the majority of pediatric sports PTs are using PROs to establish efficacy of treatment, inform clinical decision making and set goals. Inadequate time and indecision with regards to which scale to use, were identified as barriers to use. Knee disorders demonstrated the largest variability in scale use. Interestingly, the LEFS was reported at high frequencies for the hip, knee and ankle joints despite the availability of other joint specific measures available. The Oswestry and NDI are also used by 76% of respondents despite neither tool being validated in pediatrics. This finding may be due to the absence of any pediatric specific alternative measures. Clinical Relevance: The Center for Medicare and Medicaid implemented value based purchasing program per the mandate of the Affordable Care Act. The Act established a performance based approach to payment with a goal of ensuring better clinical outcomes and improved patient experience. As a result, there is an increased emphasis on using PROs to demonstrate efficacy and functional improvement. It is reassuring that many PTs are using PROs and using the obtained data to drive clinical care. However, the high variability in scale choice makes comparative outcomes research difficult. In addition, the majority of the PROs used are not validated within the pediatric population and thus may not be appropriate tools for assessing these patients perception of care delivered or even represent their functional/athletic limitations. Given the high prevalence of use and importance to clinical practice, the need for psychometric testing and/or scale development specifically for pediatric sports population is imperative.

scholarly journals Capturing PROMs in Oncology Through Consistent Nutrition Risk Identification: An Opportunity to Optimize Care by Embedding Patient Participation Facilitated by eHealth Tools

2021 ◽  
pp. 1-2
Author(s):  
Susana  Couto Irving 
Keyword(s):  
Outcome Measures ◽  
Patient Participation ◽  
Cancer Care ◽  
Clinical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Risk Identification ◽  
Nutrition Status ◽  
Pancreatic Tumors ◽  
Patient Reported

Patient-reported outcome measures obtained via E-Health tools ease the assessment burden and encourage patient participation in cancer care (PaCC Study). <b>Background:</b> E-health based patient-reported outcome measures (PROMs) have the potential to automate early identification of both nutrition status and distress status in cancer patients while facilitating treatment and encouraging patient participation. This cross-sectional study assessed the acceptability, accuracy, and clinical utility of PROMs collected via E-Health tools among patients undergoing treatment for stomach, colorectal, and pancreatic tumors. <b>Results:</b> Eight-nine percent mostly, or completely, agreed that PROMs via tablets should be integrated in routine clinical care. Men were significantly more likely to require help completing the questionnaires than women (inv.OR = 0.51, 95% CI = (0.27, 0.95), p = 0.035). The level of help needed increased by 3% with each 1-year increase in age (inv. OR = 1.03, 95% CI = (1.01, 1.06), p = 0.013). On average, a patient tended to declare weight which was 0.84 kg inferior to their true weight (Bland and Altman 95 % CI = (–3.9, 5.6); SD: 2.41) and a height which was 0.95 cm superior to their true height (Bland and Altman 95 % CI = (−5, 3.1); SD 2.08). Patient-reported nutrition status was significantly associated with the professionally generated assessment (95% CI = (2.27, 4.15), p &#x3c; 0.001). As nutrition status declined, the distress score increased (95%CI = (0.88, 1.68), p &#x3c; 0.001). Of the patients, 48.8% who were both distressed and malnourished requested supportive care to address their problems. <b>Conclusion:</b> Patient-reported assessments utilizing E-health tools are an accurate and efficient method to encourage patient participation in cancer care while simultaneously ensuring that regular assessment of psycho-social and nutritional aspects of care are efficiently integrated in the daily clinical routine.

scholarly journals Patient-reported outcome measures in systemic sclerosis–related interstitial lung disease for clinical practice and clinical trials

2020 ◽  
Vol 5 (2_suppl) ◽  
pp. 48-60
Author(s):  
Lesley Ann Saketkoo ◽  
Mary Beth Scholand ◽  
Matthew R. Lammi ◽  
Anne-Marie Russell
Keyword(s):  
Clinical Practice ◽  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Outcome Measures ◽  
Symptom Burden ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
Science Methodology

Systemic sclerosis (SSc) is a progressive vasculopathic, fibrosing autoimmune condition, portending significant mortality; wherein interstitial lung disease (ILD) is the leading cause of death. Although lacking a definitive cure, therapeutics for (SSc-ILD) that stave progression exist with further promising primary and adjuvant compounds in development, as well as interventions to reduce symptom burden and increase quality of life. To date, there has been a significant but varied history related to systemic sclerosis–related interstitial lung disease trial design and endpoint designation. This is especially true of endpoints measuring patient-reported perceptions of efficacy and tolerability. This article describes the underpinnings and complexity of the science, methodology, and current state of patient-reported outcome measures used in (SSc-ILD) systemic sclerosis–related interstitial lung disease in clinical practice and trials.

scholarly journals The impact of patient-reported outcome measures in clinical practice for pain: a systematic review

2016 ◽  
Vol 26 (2) ◽  
pp. 245-257 ◽  
Author(s):  
Michelle M. Holmes ◽  
George Lewith ◽  
David Newell ◽  
Jonathan Field ◽  
Felicity L. Bishop
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
The Impact

scholarly journals The Patient-Reported Outcome Measures Used with Low Back Pain and the Attitude of Primary Healthcare Practitioners in Saudi Arabia toward Them

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 812
Author(s):  
Ahmed Alhowimel ◽  
Faris Alodaibi ◽  
Mazyad Alotaibi ◽  
Dalyah Alamam ◽  
Julie Fritz
Keyword(s):  
Primary Care ◽  
Saudi Arabia ◽  
Outcome Measures ◽  
Primary Care Physicians ◽  
Physical Therapists ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Low Back ◽  
Knowledge And Beliefs ◽  
Patient Reported

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.

scholarly journals Attitudes, experiences, and preferences of ophthalmic professionals regarding routine use of patient-reported outcome measures in clinical practice

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243563
Author(s):  
Alexandra O. Robertson ◽  
Valerija Tadić ◽  
Jugnoo S. Rahi
Keyword(s):  
Clinical Practice ◽  
Pilot Study ◽  
Focus Group ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Training Needs ◽  
Barriers And Enablers ◽  
Patient Reported ◽  
Paediatric Ophthalmology

Background/Objectives Routine use of patient-reported outcome measures (PROMs) to assess quality of health care systems is mandated in many countries and has been implemented successfully in many specialities. Ophthalmology currently lags behind. To support and inform future implementation, we investigated paediatric ophthalmic clinicians’ experience of, and future training needs for, using child-appropriate vision PROMs and their views about the barriers and enablers to future routine implementation in clinical practice. Methods We conducted a pilot study, using an online survey to elicit the experience, attitudes, training needs and perceptions of barriers and enablers to routine PROMs use of ophthalmic health professionals in the Paediatric Ophthalmology Department at Great Ormond Street Hospital, London. A focus-group was undertaken to discuss survey results and preferences regarding presentation of PROM data. Analysis comprised descriptive statistics, presented alongside complementary qualitative data. Results Eighteen clinicians in the department completed the survey. Twenty-seven took part in the focus group. Clinicians had limited experience of using PROMs but high confidence in the potential positive impact on communication with patients, monitoring chronic conditions and clinical decision-making. Clinicians identified operational issues (collection and analysis of data) and impact (interpretation and application of data) as the two key areas for consideration. Training and information requirements before implementation were clearly articulated, alongside the benefits of using digital/electronic data capture ahead of consultations to allow efficiency and automated analysis, and presentation in an appropriate visual format alongside clinical data to ensure meaningful use. Conclusion The findings of this pilot study of ophthalmic clinicians working in a specialist paediatric ophthalmology department, suggest that ophthalmic clinicians recognise the potential benefits of routine PROMs use in clinical practice. Together with existing literature outside ophthalmology relating to overcoming barriers and exploiting enablers to routine implementation, findings may be applicable in planning routine PROM implementation in paediatric ophthalmology.

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