The BMJ Open has published an article which looks at stakeholder views on the development of patient reported outcome measures for long term conditions (LTCs).
31 interviews were conducted with stakeholders from primary care, secondary care, social care, policy and patient-focused voluntary organisations in England.
Patient-reported outcome measures (PROMs) have been proposed as a technology that may strengthen patient engagement and enable individualisation of care. There was broad support for a single PROM that could be used to measure outcomes for patients with any LTCs in any health or social care setting.
The potential use of a PROM at the individual level was prioritised over use to inform population-level service monitoring. Interviewees identified three desired uses for a PROM:
- To improve the quality of individual care
- To increase people’s engagement in their own care
- To monitor the performance of services
Stakeholders endorsed a broad range of traditional as well as non-traditional domains, such as functioning, quality of life, empowerment, social participation, the experience of services and feeling supported by services.
Most participants saw a PROM as a tool that could be used at the level of the patient–practitioner interaction. The PROM would be used to open up a conversation about outcomes and needs, and then inform health and/or care decisions. In this use, both patient and practitioner were envisaged as active participants in decision-making and in performing actions arising from the conversation.
The use of a PROM to enable the active involvement of patients in their own care was strongly supported by the majority of participants, but some participants were uncertain around how best to achieve this type of involvement.
It was felt that a PROM could facilitate patient empowerment, as it would encourage patients to reflect on their progress and receive information back on how they were doing in comparison to others, and with their own previous scores. Feeding information into services about their outcomes could also enable patients to shape and affect service provision.
Stakeholders emphasised the need for a PROM to be feasible for practical implementation at the individual clinical level as a first priority. A number of concerns and potential problems were identified in relation to the application and interpretation of an LTC PROM.
The full article can be read here.
Perspectives from health, social care and policy stakeholders on the value of a single self-report outcome measure across long-term conditions: a qualitative study
Cheryl Hunter, Ray Fitzpatrick, Crispin Jenkinson, Anne-Sophie Emma Darlington, Angela Coulter, Julien E Forder, Michele Peters
BMJ Open 2015;5:e006986 doi:10.1136/bmjopen-2014-006986