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Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 4: patient-reported outcomes can inform clinical decision making in chronic care.

ABSTRACT: BACKGROUND:Providing patient-centered health care requires that patient needs, preferences, and valued outcomes are more fully integrated into all decisions. Patient-reported outcome (PRO) measures provide unique information from the patient perspective on overall health, symptoms, burden, and treatment response. OBJECTIVE:We sought to describe applications of PROs in clinical settings and considerations for implementation from the perspectives of PRO researchers, clinicians, administrators, policy makers, and patients attending a multidisciplinary meeting. DISCUSSION:Clinical applications of PROs include individual level use for medical decision making and aggregate use for comparative effectiveness research, program evaluation, quality improvement, and performance assessments. Considerations of feasibility on workflow impact and patient burden, display of results, and administration frequency are important. PROs with strong psychometric properties, actionable thresholds, and interpretable results should be selected. We provide current exemplars of PRO use in various clinical applications, initial lessons learned, and highlight conceptual, logistical, and consequential considerations of PRO data collection. A research agenda is proposed to address critical knowledge gaps. In conclusion, PROs can be used in clinical settings to support patient-centered care. This requires an assessment of feasibility in the intended setting of use, measurement considerations, and process measures to optimize integration and use.

SUBMITTER: Bingham CO

PROVIDER: S-EPMC6529209 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 4: patient-reported outcomes can inform clinical decision making in chronic care.

Bingham Clifton O CO Noonan Vanessa K VK Auger Claudine C Feldman Debbie E DE Ahmed Sara S Bartlett Susan J SJ

Journal of clinical epidemiology 20170420

<h4>Background</h4>Providing patient-centered health care requires that patient needs, preferences, and valued outcomes are more fully integrated into all decisions. Patient-reported outcome (PRO) measures provide unique information from the patient perspective on overall health, symptoms, burden, and treatment response.<h4>Objective</h4>We sought to describe applications of PROs in clinical settings and considerations for implementation from the perspectives of PRO researchers, clinicians, admi ...[more]

PMID: 28433678

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Project description:BACKGROUND:The successful implementation of patient-reported outcomes (PROs) in clinical routine faces many challenges, first and foremost the lack of consideration thereof in the patient care process. The aim of this study will be to first identify relevant barriers and facilitators and then design suitable implementation strategies which will be evaluated to improve the effectiveness of a PRO measure assessment in inpatient and outpatient cancer routine care. METHODS:During the preparation phase, interviews with oncological patients (N = 28) and medical staff (N = 4) as well as focus groups with medical staff (N = 18) across five different departments caring for cancer patients were conducted. On the basis of these, qualitative content analysis revealed relevant barriers and facilitators for implementation of PROs in cancer care. Subsequently, implementation strategies and a model of implementation were developed. In the study phase, implementation strategies will be evaluated based on nine different implementation outcomes in five different oncological clinics. Evaluation of the implementation process will take place during three months in each clinic and data will be conducted pre, while and post implementation of the PRO measure. Therefore a sample size of 60 participants of whom 30 staff members and 30 participants will be questioned using existing and newly developed implementation outcome evaluation instruments. DISCUSSION:Key to improving the effectiveness of PRO assessment in the time-critical clinical environment is the utilization of easy-to-use, electronic PRO questionnaires directly linked to patients' records thereby improving consideration of PROs in patient care. In order to validate the effectiveness of this implementation process further, an evaluation parallel to implementation following an observational study design with a mixed-methods approach will be conducted. This study could contribute to the development of adequate evaluation processes of implementation of PROs to foster sustainable integration of PRO measures into routine cancer care. TRIAL REGISTRATION:This study was registered at Open Science Framework (https://osf.io/y7xce/).

Dataset Information

Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 4: patient-reported outcomes can inform clinical decision making in chronic care.

Publications

Montreal Accord on Patient-Reported Outcomes (PROs) use series - Paper 4: patient-reported outcomes can inform clinical decision making in chronic care.

Similar Datasets

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