Quality of primary care from the patient’s point of view. A systematic review. There is currently no acceptable tool for practice or research purposes.

Background To run an inventory of instruments which assess quality of care from the patients’ experiences in primary care, in the context of multi-disciplinary health-care centres and which appraise their measurement quality, taking into account the methodological quality of their validation studies. Method Systematic review using Medline, Pascal, PsycINFO, Google Scholar, Cochrane, Scopus and CAIRN. For each instrument identified, the level of evidence was assessed using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist; the appraisal of the psychometric quality of the measurement property using three possible quality scores and the best-evidence synthesis based on the number of studies, their methodological and psychometric quality, and the direction and consistency of the results. Details of the subscales used to capture patients’ experiences of primary care were extracted and synthesized by grouping them into 9 dimensions defined by the Institute Of Medicine (IOM). Results 29 articles describing 29 instruments were found. Constructs captured by the assessment tools included illustrated a diversity of conceptualizations of patients’ experiences of primary care. There was no clear consensus across the assessment tools included about what patient experience in primary care ought to measure. There is an overall lack of evidence of their measurement quality, either because validation is missing or because methods are poor. Conclusion Due to the lack of evidence, the choice for the most appropriate instrument is difficult. Improvement and validation of existing instruments, and the use of COSMIN-guidelines could help make evaluations more effective.