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1
Cornelis, Cosette, Sanne J. den Hartog, Carla M. Bastemeijer, Bob Roozenbeek, Paul J. Nederkoorn, and Renske M. Van den Berg-Vos. "Patient-Reported Experience Measures in Stroke Care." Stroke 52, no. 7 (July 2021): 2432–35. http://dx.doi.org/10.1161/strokeaha.120.034028.
Анотація:
Background and Purpose: Patient-reported experience measures (PREMs) assess patients’ perception of health care. We aimed to identify all reported PREMs for stroke care and critically appraise psychometric properties of PREMs validated for patients with stroke. Methods: Studies on the development, validation, or utilization of PREMs for adult patients with stroke were systematically identified. The Consensus-Based Standards for the Selection of Health Measurement Instruments criteria were used to appraise psychometric performance. Results: We included 18 studies, examining 13 PREMs. Two PREMs had been developed for stroke care: Consumer Quality Index: Cerebrovascular Accident and Riksstroke. Consumer Quality Index: Cerebrovascular Accident was given a positive psychometric assessment, but its length and limited language applicability impede clinical implementation. Riksstroke was appraised as doubtful. Eleven PREMs were generic. The psychometric performance of 5 generic PREMS, validated for patients with stroke, received conflicting assessments. Six generic PREMs had not been validated in patients with stroke and were therefore not assessed for instrument performance. Conclusions: Thirteen PREMs have been published for use in stroke care. The stroke-specific Consumer Quality Index: Cerebrovascular Accident has favorable psychometric performance but lacks practical feasibility. Other PREMs have inadequate or unknown psychometric properties. This indicates the need for developing stroke-specific PREMs to support quality improvement and enhance patient-centered care.
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Mihaljevic, Andre L., Colette Doerr-Harim, Eva Kalkum, and Guido Strunk. "Measuring patient centeredness with German language Patient-Reported Experience Measures (PREM)–A systematic review and qualitative analysis according to COSMIN." PLOS ONE 17, no. 11 (November 29, 2022): e0264045. http://dx.doi.org/10.1371/journal.pone.0264045.
Анотація:
Background Patient centeredness is an integral part of the quality of care. Patient-reported experience measures (PREMs) are assumed to be an appropriate tool to assess patient-centredness. An evaluation of German-speaking PREMs is lacking. Objective To perform a systematic review and qualitative analysis of psychometric measurement qualities of German-language PREMs using for the first time a comprehensive framework of patient centredness. Methods A systematic literature search was performed in Medline, PsycInfo, CINHAL, Embase, Cochrane database (last search 9th November 2021) for studies describing generic, surgery- or cancer care-specific PREMs. All questionnaires that were developed in or translated into German were included. The content of the included PREMs was evaluated using a comprehensive framework of patient centredness covering 16 domains. Baseline data of all PREM studies were extracted by two independent reviewers. Psychometric measurement qualities of the PREMs were assessed using current COSMIN guidelines. Results After removal of duplicates 3,457 abstracts were screened, of which 3,345 were excluded. The remaining 112 articles contained 51 PREMs, of which 12 were either developed in (4 PREMs) or translated into German (8 PREMs). Eight PREMs were generic (NORPEQ, PPE-15, PEACS, HCAHPS, QPPS, DUQUE, PEQ-G, Schoenfelder et al.), 4 cancer care-specific (EORTC IN-PATSAT32, PSCC-G, Danish National Cancer Questionnaire, SCCC) and none was surgery-specific. None of the PREMs covered all domains of patient-centeredness. Overall rating of structural validity was adequate only for PEACS and HCAHPS. High ratings for internal consistency were given for NORPEQ, Schoenfelder et al., PSCC-G and the SCCC. Cross-cultural validity for translated questionnaires was adequate only for the PSCC-G, while reliability was adequately assessed only for the EORTC IN-PATSAT32. Due to a lack of measurement gold standard and minimal important change, criterion validity and measurement invariance could not be assessed for any of the PREMs. Conclusion This is the first systematic review using a comprehensive framework of patient centredness and shows that none of the included PREMs, even those translated from other languages into German, cover all aspects of patient centredness. Furthermore, all included PREMS show deficits in the results or evaluation of psychometric measurement properties. Nonetheless, based on the results, the EORTC IN-PATSAT32 and PSCC-G can be recommended for use in cancer patients in the German-language region, while the German versions of the HCAHPS, NORPEQ, PPE-15 and PEACS can be recommended as generic PREMs. Trial Registration Registration. PROSPERO CRD42021276827.
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Wray, Jo, Sylvie Hobden, Sarah Knibbs, and Geralyn Oldham. "Hearing the voices of children and young people to develop and test a patient-reported experience measure in a specialist paediatric setting." Archives of Disease in Childhood 103, no. 3 (September 13, 2017): 272–79. http://dx.doi.org/10.1136/archdischild-2017-313032.
Анотація:
ObjectiveTo develop and test patient-reported experience measures (PREMs) for children and young people in a specialist paediatric hospital setting.DesignSix PREMs were developed and tested by children and young people for children and young people aged 8–11, 12–13 and 14–16 years in inpatient and outpatient settings. A week-long pilot was implemented across inpatient wards and outpatient clinics to identify facilitators and barriers to the routine use of PREMs in a real-time setting across our organisation.SettingTertiary paediatric hospital.Main outcome measuresFinal PREMs; identified facilitators and barriers to implementation.Participants543 children and young people aged 8–16 years attending outpatient clinics or inpatient wards across a range of specialties.ResultsThree key themes about hospital experience were identified during focus groups: facilities, treatment and tests and people working at the hospital, and these provided the structure for the questionnaires. During cognitive testing the questionnaires were generally understood but some revisions to language and length of the questionnaires were required. Two designs were selected for the final PREMs. During acceptability and feasibility testing it was evident that children and young people liked the PREMs and wanted to give feedback on their hospital experience. Particular challenges for routine use of the PREMs focused on sustainability and resources.ConclusionsThe new PREMs will provide children and young people receiving care in specialist paediatric hospitals with the opportunity to provide feedback on their experience. Sustainability and ensuring that feedback results in improvements need to be addressed in future work.
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Rosvall, Annica, Magdalena Annersten Gershater, Christine Kumlien, Ervin Toth, and Malin Axelsson. "Patient-Reported Experience Measures for Colonoscopy: A Systematic Review and Meta-Ethnography." Diagnostics 12, no. 2 (January 19, 2022): 242. http://dx.doi.org/10.3390/diagnostics12020242.
Анотація:
Patient experience is defined as a major quality indicator that should be routinely measured during and after a colonoscopy, according to current ESGE guidelines. There is no standard approach measuring patient experience after the procedure and the comparative performance of the different colonoscopy-specific patient-reported experience measures (PREMs) is unclear. Therefore, the aim was to develop a conceptual model describing how patients experience a colonoscopy, and to compare the model against colonoscopy-specific PREMs. A systematic search for qualitative research published up to December 2021 in PubMed, Cochrane, CINAHL, and PsycINFO was conducted. After screening and quality assessment, data from 13 studies were synthesised using meta-ethnography. Similarities and differences between the model and colonoscopy-specific PREMs were identified. A model consisting of five concepts describes how patients experience undergoing a colonoscopy: health motivation, discomfort, information, a caring relationship, and understanding. These concepts were compared with existing PREMs and the result shows that there is agreement between the model and existing PREMs for colonoscopy in some parts, while partial agreement or no agreement is present in others. These findings suggest that new PREMs for colonoscopy should be developed, since none of the existing colonoscopy-specific PREMs fully cover patients’ experiences.
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Berghänel, Andreas, Michael Heistermann, Oliver Schülke, and Julia Ostner. "Prenatal stress accelerates offspring growth to compensate for reduced maternal investment across mammals." Proceedings of the National Academy of Sciences 114, no. 50 (November 27, 2017): E10658—E10666. http://dx.doi.org/10.1073/pnas.1707152114.
Анотація:
Across mammals, prenatal maternal stress (PREMS) affects many aspects of offspring development, including offspring growth. However, how PREMS translates to offspring growth is inconsistent, even within species. To explain the full range of reported effects of prenatal adversity on offspring growth, we propose an integrative hypothesis: developmental constraints and a counteracting adaptive growth plasticity work in opposition to drive PREMS effects on growth. Mothers experiencing adversity reduce maternal investment leading to stunted growth (developmental constraints). Concomitantly, the pace of offspring life history is recalibrated to partly compensate for these developmental constraints (adaptive growth plasticity). Moreover, the relative importance of each process changes across ontogeny with increasing offspring independence. Thus, offspring exposed to PREMS may grow at the same rate as controls during gestation and lactation, but faster after weaning when direct maternal investment has ceased. We tested these predictions with a comparative analysis on the outcomes of 719 studies across 21 mammal species. First, the observed growth changes in response to PREMS varied across offspring developmental periods as predicted. We argue that the observed growth acceleration after weaning is not “catch-up growth,” because offspring that were small for age grew slower. Second, only PREMS exposure early during gestation produced adaptive growth plasticity. Our results suggest that PREMS effects benefit the mother’s future reproduction and at the same time accelerate offspring growth and possibly maturation and reproductive rate. In this sense, PREMS effects on offspring growth allow mother and offspring to make the best of a bad start.
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Versluijs, Yvonne, Maartje Lemmers, Laura E. Brown, Amanda I. Gonzalez, Joost T. P. Kortlever, and David Ring. "The Correlation of Communication Effectiveness and Patient Satisfaction." Journal of Patient Experience 8 (January 1, 2021): 237437352199883. http://dx.doi.org/10.1177/2374373521998839.
Анотація:
This study assessed the correlation of 9 questions addressing communication effectiveness (the Communication Effectiveness Questionnaire [CEQ]) with other patient-reported experience measures (PREMs; satisfaction, perceived empathy) as well as patient-reported outcome measures (PROMs; pain intensity, activity tolerance) in patients with musculoskeletal illness or injury. In a cross-sectional study, 210 patients visiting an orthopedic surgeon completed the CEQ and measures of satisfaction with the visit, perceived empathy, pain intensity, and activity tolerance. We evaluated correlations between CEQ and other PREMs and CEQ and PROMs. We measured ceiling effects of the PREMs. Communication effectiveness correlated moderately with other PREMs such as satisfaction (ρ = 0.54; P < .001) and perceived empathy (ρ = 0.54; P < .001). Communication effectiveness did not correlate with PROMs: pain intensity (ρ = −0.01; P = .93) and activity tolerance (ρ = −0.05; P = .44). All of the experience measures have high ceiling effects: perceived empathy 37%, satisfaction 80%, and CEQ 46%. The observation of notable correlations of various PREMs, combined with their high ceiling effects, direct us to identify a likely common statistical construct (which we hypothesize as “relationship”) accounting for variation in PREMs, and then develop a PREM which measures that construct in a manner that results in a Gaussian distribution of scores. At least within the limitations of current experience measures, there seems to be no association between illness (PROMs) and experience (PREMs).
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Withers, Kathleen, Sarah Puntoni, Robert Palmer, Susan O'Connell, and Grace Carolan-Rees. "OP96 Standardizing Collection Of Patient-Reported Experience Measures To Drive Service Improvement In Wales." International Journal of Technology Assessment in Health Care 34, S1 (2018): 35. http://dx.doi.org/10.1017/s0266462318001289.
Анотація:
Introduction:Co-production relates to patients and health professionals working in equal partnership with shared decision-making. Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly being used to involve patients and measure healthcare quality. We set out to develop a set of universal experience questions for use across Wales. These will be used in various settings, including the national electronic PROMs and PREMs platform, which is already collecting outcome data across Wales and has received over 7,000 responses to date.Methods:Patient experience leads and clinical leads were invited to a workshop to discuss standardized PREMs collection in Wales, with all health boards and trusts represented. It was agreed that quantitative patient experience data collection, while limited, would be a pragmatic way to collect responses from a large cohort. It was agreed that a previously developed set of PREMs questions could be adapted for use in all healthcare settings. Patient focus groups reduced the number of questions to a shortlist of those considered most important by patients. Wording was improved and an additional question was added.Results:In partnership with stakeholders we developed and agreed on a set of universal PREMs questions. These have been added to the national electronic platform, with collection commencing imminently. This will allow patients accessing secondary care in Wales to provide PREMs and PROMs responses.Conclusions:Development of a standardized set of PREMs has allowed us to initiate collection on a national basis. Addition of PREMs to the national electronic platform provides a unique means of collecting large volumes of data consistently, allowing us to benchmark across and within organizations. It will also allow experience teams to target improvement initiatives and identify good practice. Together with outcomes responses, the data will be used to measure experience of care in Wales.
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Rogge, Alizé A., Felix Fischer, Lisa Otto, and Matthias Rose. "Empirische Erfassung patient*innenberichteter Merkmale: PROMs und PREMs." AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 57, no. 02 (February 2022): 150–55. http://dx.doi.org/10.1055/a-1452-2788.
Анотація:
ZusammenfassungAuskünfte von Patient*innen über die eigene Lebensqualität, Erfahrungen in der Versorgung sowie individuelle Einschätzungen zu Therapieverläufen und -ergebnissen gewinnen zunehmend an Bedeutung. Patient*innenberichtete Merkmale können sich auf subjektive Informationen zur eigenen Gesundheit (Patient-reported Outcome Measures [PROMs]) oder auf objektive Informationen zur Erfahrung während des Behandlungsprozesses (Patient-reported Experience Measures [PREMs]) beziehen. Dieser Artikel gibt einen Überblick über die Gemeinsamkeiten und Unterschiede von PROMs und PREMs. Anschließend werden Möglichkeiten zur Erfassung von PROMs und PREMs vorgestellt und hierbei ein Einblick in die probabilistische Testtheorie (Item-Response-Theory) sowie in das computeradaptive Testen gegeben. Am Beispiel von nationalen und internationalen Initiativen wird die Umsetzung von PROMs und PREMs in Gesundheitssystemen dargestellt und zukünftige Implementierungsstrategien innerhalb eines Ausblicks diskutiert.
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Харченко, Н. В., О. В. Харченко, Т. В. Плужнікова, Н. В. Мартиненко та А. В. Костріков. "АНАЛІЗ ПРОГРАМ PROMs І PREMs У ЗАКЛАДАХ ОХОРОНИ ЗДОРОВ’Я". Вісник соціальної гігієни та організації охорони здоров'я України, № 1 (7 липня 2022): 29–34. http://dx.doi.org/10.11603/1681-2786.2022.1.13072.
Анотація:
Мета: проаналізувати дані літературних джерел щодо використання анкет PREMs (показники досвіду, про які повідомляють пацієнти) та PROMs (показники результатів, про які повідомляють пацієнти) і визначити їх роль у покращенні поточних клінічних послуг та розробки подальших послуг як на користь пацієнтів, так і надавачів послуг.
Матеріали і методи. Проведено аналіз літературних джерел щодо використання анкет PREMs (показники досвіду, про які повідомляють пацієнти) і PROMs (показники результатів, про які повідомляють пацієнти). Використано бібліосемантичний (вивчення фахової сучасної міжнародної літератури з досліджуваної проблеми) та аналітичний методи дослідження.
Результати. Програми PROMs і PREMs доповнюють традиційні показники результатів і дають змогу краще зрозуміти результати та ефективність медичної допомоги. PROMs (показники результатів, які повідомляють пацієнти) і PREMs (показники досвіду, які повідомляють пацієнти) – це заходи, які забезпечують орієнтований на пацієнта погляд на медичну допомогу. Програми PROMs дозволяють клініцистам отримати уявлення про вплив хвороби та лікування на їх спосіб життя та якість життя. PREMs є життєздатним і надійним рішенням для оцінки заходів процесу та оцінки якості допомоги.
Висновок. Клініцисти визнали, що високоякісна клінічна допомога вимагає від пацієнтів надавати інформацію, що стосується їхніх почуттів, їх симптомів та наслідків методів лікування, які вони застосували.
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Coulthard, Paul. "Complications, PROMs and PREMs." Oral Surgery 9, no. 1 (January 28, 2016): 3. http://dx.doi.org/10.1111/ors.12209.
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Klootwijk, Anouk, Pieter Bakx, Arie Franx, Hilmar Bijma, Hiske Ernst-Smelt, Marije Lamain-de Ruiter, Anke Posthumus, and Bas van Rijn. "Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study." BMJ Open Quality 12, no. 1 (March 2023): e001922. http://dx.doi.org/10.1136/bmjoq-2022-001922.
Анотація:
BackgroundPatient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) can highlight issues that remain unnoticed when using standard clinical quality indicators. However, estimations of the potential power of measuring PROMs and PREMs to identify unrecognised areas suitable for quality improvement are often limited by a lack of reliable real-world data. Here, we report on how the indicator set for PROMs and PREMs that was recently developed by the International Consortium for Health Outcome Measures can change perspectives on quality assessment in women receiving care for pregnancy and childbirth.MethodsPROMs and PREMs were captured 6 months after childbirth via an online survey in a single academic maternity unit in the Netherlands between 2018 and 2019. Indicators of abnormality were scored using predefined cut-off values established by a national consensus group. We used regression analysis to identify associations between PROMs, PREMs and healthcare use, and further stratified data to explore the distribution of indicators among relevant patient subgroups.ResultsOf 2775 questionnaires, 645 were completed and linked to medical health records. Despite only 5% of women reporting overall dissatisfaction with care, suboptimal scores were often found; in birth experience for 32% of the population, and 42% who experienced painful sexual intercourse. Subgroup analysis further revealed associations with relevant indicators of quality of care; inadequate pain relief among women with preterm birth (OR 8.8), pain with sexual intercourse among women undergoing vaginal assisted delivery (OR 2.2) and women living in a deprived area had problematic birth experiences (coefficient −3.2).ConclusionUse of PROMs and PREMs in pregnancy and childbirth care provides new insights on quality of care, resulting in potentially actionable targets for improvement not normally identified with standard clinical quality indicators. Implementation strategies and follow-up are needed to act on these findings.
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Benson, Tim. "Why it is hard to use PROMs and PREMs in routine health and care." BMJ Open Quality 12, no. 4 (December 2023): e002516. http://dx.doi.org/10.1136/bmjoq-2023-002516.
Анотація:
Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) show the results of healthcare activities as rated by patients and others. Patients or their proxies record feedback using questionnaires. These can enhance quality for all and tailored care for individuals. This paper describes obstacles that inhibit widespread use of PROMs and PREMs and some potential solutions.Implementation is a prerequisite for any innovation to succeed. Health and care services are complex and people need to be engaged at every level. Most people are cautious about proven innovations such as PROMs and PREMs but champions and leaders can help them engage. The NASSS framework (reasons for Non-adoption, Abandonment and failure to Scale up, Spread or Sustain digital health innovations) helps indicate that implementation is complex why it may be resisted.The Plan-Do-Study-Act (PDSA) approach aids implementation and helps ensure that everyone knows who should do what, when, where, how and why. Noise is an under-appreciated problem, especially when tracking patients over time such as before and after treatment. Interoperability of PROMs and PREMs with electronic health records should use Fast Health Interoperability Resources and internationally accepted coding schemes such as SNOMED CT and LOINC.Most projects need multiple measures to meet the needs of everyone involved. Measure selection should focus on their relevance, ease of use, and response rates.If these problems are avoided or mitigated, PROMs and PREMs can help deliver better patient outcomes, patient experience, staff satisfaction and health equity.
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Bandurska, Ewa. "The Voice of Patients Really Matters: Using Patient-Reported Outcomes and Experiences Measures to Assess Effectiveness of Home-Based Integrated Care—A Scoping Review of Practice." Healthcare 11, no. 1 (December 28, 2022): 98. http://dx.doi.org/10.3390/healthcare11010098.
Анотація:
Background: The aim of the study is to analyze the prevalence of using patients’ reported outcomes measures and experiences (PROMs and PREMs) in relation to integrated care (IC). Material and methods: To select eligible studies (<10 years, full-text), PubMed was used. The general subject of the articles referring to the type of disease was indicated on the basis of a review of all full-text publications discussing the effectiveness of IC (N = 6518). The final search included MeSH headings related to outcomes measures and IC. Full-text screening resulted in including 73 articles (23 on COPD, 40 on diabetes/obesity and 10 on depression) with 93.391 participants. Results: Analysis indicated that authors used multiple outcome measures, with 54.8% of studies including at least one patient reported. PROMs were more often used than PREMs. Specific (disease or condition/dimension) outcome measures were reported more often than general, especially those dedicated to self-assessment of health in COPD and depression. PROMs and PREMs were most commonly used in studies from the USA and Netherlands. Conclusion: Using PROMS/PREMS is becoming more popular, although it is varied, both due to the place of research and type of disease.
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Glenngård, Anna H., and Anders Anell. "Process measures or patient reported experience measures (PREMs) for comparing performance across providers? A study of measures related to access and continuity in Swedish primary care." Primary Health Care Research & Development 19, no. 01 (September 15, 2017): 23–32. http://dx.doi.org/10.1017/s1463423617000457.
Анотація:
AimTo study (a) the covariation between patient reported experience measures (PREMs) and registered process measures of access and continuity when ranking providers in a primary care setting, and (b) whether registered process measures or PREMs provided more or less information about potential linkages between levels of access and continuity and explaining variables.BackgroundAccess and continuity are important objectives in primary care. They can be measured through registered process measures or PREMs. These measures do not necessarily converge in terms of outcomes. Patient views are affected by factors not necessarily reflecting quality of services. Results from surveys are often uncertain due to low response rates, particularly in vulnerable groups. The quality of process measures, on the other hand, may be influenced by registration practices and are often more easy to manipulate. With increased transparency and use of quality measures for management and governance purposes, knowledge about the pros and cons of using different measures to assess the performance across providers are important.MethodsFour regression models were developed with registered process measures and PREMs of access and continuity as dependent variables. Independent variables were characteristics of providers as well as geographical location and degree of competition facing providers. Data were taken from two large Swedish county councils.FindingsAlthough ranking of providers is sensitive to the measure used, the results suggest that providers performing well with respect to one measure also tended to perform well with respect to the other. As process measures are easier and quicker to collect they may be looked upon as the preferred option. PREMs were better than process measures when exploring factors that contributed to variation in performance across providers in our study; however, if the purpose of comparison is continuous learning and development of services, a combination of PREMs and registered measures may be the preferred option. Above all, our findings points towards the importance of a pre-analysis of the measures in use; to explore the pros and cons if measures are used for different purposes before they are put into practice.
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Cook, Olivia, Yunyun Daiyan, Ladan Yeganeh, Amy Georgina Davies, Alastair Kwok, Kate Webber, and Eva Segelov. "Exploration of the use and impact of patient-reported experience measures (PREMs) in oncology settings: A systematic review." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 166. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.166.
Анотація:
166 Background: In addition to patient-reported outcome measures, the use of patient-reported experience measures (PREMs) is also developing as a patient-centred method for evaluating health performance. PREMs are tools that measure patients’ experience of health care including accessibility, the physical environment of services, and their interactions with health service providers and clinicians. This systematic review aimed to explore the use and impact of PREMs in the clinical care of cancer patients and survivors. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. An a priori protocol was established and systematic searches of major databases (CINAHL, Medline, PsycINFO, Ovid Emcare and Scopus) were conducted between 2009 and 2019. Quantitative studies of adult or paediatric populations were eligible for inclusion. Articles reporting patient satisfaction only were excluded. Quality appraisal was conducted using the Johanna Briggs Institute Critical Appraisal Tools. A narrative synthesis of findings was conducted. Results: A total of 3246 articles were screened for eligibility with 45 studies included in the systematic review. The majority of included studies (n=37) were cross-sectional in design with a variety of PREMs used, most commonly the National Cancer Patient Experience Survey. Most studies were assessed as ‘moderate’ to ‘high’ for quality. Studies were categorised according to the use of the PREM with the majority (n=40) utilising a PREM to evaluate cancer services at the service or national level, and five using a PREM to evaluate a specific clinical intervention. Various gaps in care were identified across studies highlighting areas for improvement such as time to diagnosis and information provision. Few studies reported the barriers or enablers to PREM collection or discussed service improvement initiatives arising from them. Conclusions: Whilst PREM collection is becoming more common in oncology settings, the use and impact of this valuable data is not well reported. Patients willingly share their experiences of oncology care, yet planned or complete actions resulting from the data to improve care are seldom reported. The collection of PREMs should be met with a commitment to service improvement and longitudinal collection of PREMs is recommended to evaluate quality improvement initiatives.
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Blood, Zachary, Anh Tran, Lauren Caleo, Robyn Saw, Mbathio Dieng, Mark Shackleton, H. Peter Soyer, Chris Arnold, Graham J. Mann, and Rachael L. Morton. "Implementation of patient-reported outcome measures and patient-reported experience measures in melanoma clinical quality registries: a systematic review." BMJ Open 11, no. 2 (February 2021): e040751. http://dx.doi.org/10.1136/bmjopen-2020-040751.
Анотація:
ObjectivesTo identify patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in clinical quality registries, for people with cutaneous melanoma, to inform a new Australian Melanoma Clinical Outcomes Registry; and describe opportunities and challenges of routine PROM/PREM collection, especially in primary care.DesignSystematic review.Primary and secondary outcome measuresWhich PROMs and PREMs are used in clinical quality registries for people with cutaneous melanoma, how they are collected, frequency of collection, participant recruitment methods and funding models for each registry.Results1134 studies were identified from MEDLINE, PreMEDLINE, Embase, PsychInfo, Cochrane Database of Abstracts of Reviews of Effects databases and TUFTS Cost-Effectiveness Analysis Registry, alongside grey literature, from database inception to 5th February 2020. Following screening, 14 studies were included, identifying four relevant registries: Dutch Melanoma Registry, Adelphi Real-World Disease-Specific Programme (Melanoma), Patient-Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship Registry, and Cancer Experience Registry. These used seven PROMs: EuroQol-5 Dimensions, Functional Assessment of Cancer-General (FACT-G) and FACT-Melanoma (FACT-M), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Cancer 30 (EORTC QLQ-C30), Fatigue Assessment Scale Hospital Anxiety and Depression Scale, Patient-Reported Outcome Measures Information System-29 and one PREM; EORTC QLQ-Information Module 26. PROMs/PREMs in registries were reported to improve transparency of care; facilitate clinical auditing for quality assessment; enable cost-effectiveness analyses and create large-scale research platforms. Challenges included resource burden for data entry and potential collection bias toward younger, more affluent respondents. Feedback from patients with melanoma highlighted the relevance of PROMs/PREMs in assessing patient outcomes and patient experiences.ConclusionsClinical registries indicate PROMs/PREMs for melanoma care can be incorporated and address important gaps, however cost and collection bias may limit generalisability.PROSPERO registration numberCRD42018086737.
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Krawczyk, Marian, Richard Sawatzky, Kara Schick-Makaroff, Kelli Stajduhar, Joakim Öhlen, Sheryl Reimer-Kirkham, Esther Mercedes Laforest, and Robin Cohen. "Micro-Meso-Macro Practice Tensions in Using Patient-Reported Outcome and Experience Measures in Hospital Palliative Care." Qualitative Health Research 29, no. 4 (March 15, 2018): 510–21. http://dx.doi.org/10.1177/1049732318761366.
Анотація:
This article applies a micro-meso-macro analytical framework to understand clinicians’ experiences and perspectives of using patient-reported outcome and experience measures (PROMs and PREMs) in routine hospital-based palliative care. We structure our discussion through qualitative analysis of a design and implementation project for using an electronic tablet-based tool among hospital-based palliative clinicians to assess patients’ and their family caregivers’ quality of life concerns and experiences of care. Our analysis identified three categories of practice tensions shaping clinicians’ use of PROMs and PREMs in routine care: tensions surrounding implementation, tensions in standardization and quantification, and tensions that arose from scope of practice concerns. Our findings highlight that clinicians necessarily work within the confluence of multiple system priorities, that navigating these priorities can result in irreducible practice tensions, and that awareness of these tensions is a critical consideration when integrating PROMs and PREMs into routine practice.
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Bull, Claudia, Helena Teede, Lane Carrandi, Azure Rigney, Sally Cusack, and Emily Callander. "Evaluating the development, woman-centricity and psychometric properties of maternity patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs): A systematic review protocol." BMJ Open 12, no. 2 (February 2022): e058952. http://dx.doi.org/10.1136/bmjopen-2021-058952.
Анотація:
IntroductionWoman-centred care is the right of every woman receiving maternity care, irrespective of where care is being received and who is providing care. This protocol describes a planned systematic review that will identify, describe and critically appraise the psychometric properties of maternity patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). The woman-centricity of PROM and PREM development and content validation (ie, the extent to which women were involved in these processes) will also be assessed. This information will be used to develop a maternity PROMs and PREMs database to support service and system performance measurement, and value-based maternity care initiatives.Methods and analysisThis study will be guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline for systematic reviews of outcome measurement instruments. Studies identified via MEDLINE, CINAHL Plus, PsycINFO and EMBASE describing the development, content validation and/or psychometric evaluation of PROMs and PREMs specifically designed for maternity populations throughout pregnancy, childbirth and postnatal periods will be considered if published from 2010 onward, in English, and available in full text. The COSMIN risk of bias checklist will be used to evaluate the quality of studies reporting on the development, content validation and/or psychometric evaluation of PROMs and PREMs. COSMIN criteria for good content validity will be used to assess the woman-centricity of PROM and PREM development and content validation studies. COSMIN standards of good psychometric properties will be used to evaluate the validity and reliability of the identified instruments.Ethics and disseminationEthical permission for this research is not required. The findings of this research will be submitted for publication in an international, peer-reviewed journal. Abstracts for national and international conference presentations will also be submitted. The proposed maternity PROMs and PREMs database will be freely accessible online, and developed with consumer input to ensure its usefulness to a range of maternity care stakeholders.PROSPERO registration numberCRD42021288854.
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Karoli, Peter M., Grace A. Shayo, Elizabeth H. Shayo, Christine V. Wood, Theresia A. Ottaru, Claudia A. Hawkins, Erasto V. Mbugi, et al. "Patient reported experience measures on HIV viral load testing at public health facilities in Dar es Salaam, Tanzania: A convergent mixed method study." PLOS Global Public Health 3, no. 4 (April 7, 2023): e0001024. http://dx.doi.org/10.1371/journal.pgph.0001024.
Анотація:
While viral load (VL) testing is critical to effective treatment of human immunodeficiency virus (HIV), little is known about patients’ experiences with, and barriers to VL-testing in the context of HIV infection. We assessed patient reported experience measures (PREMs) on VL-testing in public HIV clinics in Tanzania. In a cross-sectional convergent mixed method study, we collected information on VL test related PREMs, clinical and sociodemographic factors. PREMs were measured using a 5-point Likert scale. Focus Group Discussions (FGDs) explored on experience, access, and barriers to VL-testing. Descriptive statistics summarized patients’ factors and PREMs. Logistic regression was used to explore association of patient factors, PREMs and satisfaction with VL-testing services. Thematic analysis was used for qualitative data. A total of 439 (96.48%) respondents completed the survey, 331 (75.40%) were female, median (IQR) age was 41(34, 49) years. A total of 253(57.63%) had a VL test at least once in the past 12 months, of whom 242(96.0%) had VL<1000 copies/ml. Investigating barriers to VL-testing, most participants (>92.0%) reported good or very good health services responsiveness (HSR). A scale of very good was chosen by the majority for being treated with respect 174(39.6%), listened to 173(39.4%), following advice 109(24.8%), being involved in decisions 101(23.0%), and for communication 102(23.3%). Satisfaction on VL-testing services was significantly associated with respondents following care providers’ advice, (aOR) = 2.07 [95%CI 1.13–3.78], involvement in decisions aOR = 4.16 [95%CI 2.26–7.66], and communication aOR = 2.27 [95%CI 1.25–4.14]. FGDs findings converged with the survey data, with identified barriers to VL test including lack of autonomy in decision making, little awareness on the benefits of the test, long waiting time, stigma, competing priorities for those with comorbidities and transport costs. Satisfaction on VL-testing was largely a result of involvement in decision making, following care provider’s advice and good communication; entities needing universal improvement across the country.
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Pana, Bogdan C., Ciprian Paul Radu, Florentina L. Furtunescu, Adrian Mociu, and Nicolae Ciufu. "Utility and Utilization of Patient-Reported Experience Measures for the Supplementary COVID-19 Protective Actions at the Ovidius Clinical Hospital in Romania." Healthcare 12, no. 3 (February 1, 2024): 377. http://dx.doi.org/10.3390/healthcare12030377.
Анотація:
Patient-reported experience measures (PREMs) provide assessments of patients’ subjective experiences and perceptions regarding their interactions with the healthcare system and its services. We present a cross-sectional study of the patient perception and evolution of COVID-19 cases performed at Ovidius Clinical Hospital in Romania during the COVID-19 pandemic. The study objective is to explore the utility and the utilization of PREMs in monitoring patient perceptions of the supplementary protective actions. During the pandemic, the hospital implemented early supplementary protective actions, like PCR and lung CT, to all surgically admitted patients in the hospital alongside government-recommended actions. At the same time, functional PREMs were used to evaluate patient perceptions regarding these supplementary actions. The research was carried out for 19 months between June 2020 and December 2021. The findings revealed that opinions about the severity of the COVID-19 pandemic, the personal risk of infection, and the perception of protective actions in the hospital were not correlated. Conclusions: The patients’ appreciation of the COVID-19 protective actions taken by the hospital is related more to the general perceptions induced by the number of cases presented in the mass media and less by perceptions of the gravity of the problem or the risk of infection. In a hospital, the primary mission of patient safety is essential, and it must be fulfilled even if the patients are not sure or fully convinced that this is for their benefit. For management decisions and monitoring, using PREMs can be essential in a situation when general evidence is not conclusive.
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Pennucci, Francesca, Sabina De Rosis, and Claudio Passino. "Piloting a web-based systematic collection and reporting of patient-reported outcome measures and patient-reported experience measures in chronic heart failure." BMJ Open 10, no. 10 (October 2020): e037754. http://dx.doi.org/10.1136/bmjopen-2020-037754.
Анотація:
ObjectivesTo evaluate the feasibility of a digital and continuous collection and reporting of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) for chronic heart failure (CHF).DesignA single-site pilot study was settled for evaluating the feasibility of the intervention, both using qualitative and quantitative data (ie, workshop, surveys).SettingThe pilot has been implemented in a Tuscan specialised hospital (Italy).Participants162 patients were involved. Inclusion criteria were: a previous diagnosis of HF, age ≥18 years, absence of cognitive impairment or active tumours, ability to provide informed consent to study participation.InterventionThe continuous collection and reporting of PROMs and PREMs has been designed and implemented in 2018. PREMs questionnaires for patients were developed, while Kansas City Cardiomyopathy Questionnaire-12 was used for assessing PROMs. Questionnaires are administered at specific time points: discharge; 30 days, 7 and 12 months after the discharge. Enrolment of patients, administration and real-time reporting of questionnaires are carried on through a digital platform.Outcome measuresEnrolment, response and drop-out rates were considered to assess the feasibility of the intervention. Qualitative data were collected during meetings and workshops with health workers. The representativeness of the recruited sample with respect to the population characteristics was also evaluated.ResultsThe system has been successfully implemented during 2018. Response rates have been consistently above 50%, demonstrating patients’ transversal willingness to participate. All the involved stakeholders acknowledged the feasibility of the design. The recruited sample is significantly different in terms of age and educational level compared with the overall population characteristics.ConclusionIt is possible to run a web-based systematic collection and reporting system for CHF patient-reported data. Systematic collection and reporting of PROMs and PREMs data allows professionals to increasingly assume CHF patient perspective in their daily work. Limitations will be used to improve the system.
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Al-Rashdan, Abdulla, Linda Watson, Demetra Yannitsos, Siwei Qi, Petra Grendarova, and Lisa Barbera. "Comparison of Patient-Reported Experience of Patients Receiving Radiotherapy Measured by Two Validated Surveys." Current Oncology 28, no. 3 (June 12, 2021): 2180–89. http://dx.doi.org/10.3390/curroncol28030202.
Анотація:
Patient-reported experience is associated with improved patient safety and clinical outcomes. Quality improvement programs rely on validated patient-reported experience measures (PREMs) to design projects. This descriptive study compares the experience of cancer patients treated with radiation as recorded through the Ambulatory Oncology Patient Satisfaction Survey (AOPSS) or as recorded through Your Voice Matters (YVM) between February and August 2019. Six questions were compared (“overall experience with care”, “discussion of worries”, “involvement in decisions”, “trusting providers with confidential information”, “providing family with information”, and “knowing who to contact”). Positive experience scores were calculated by cohort and by tumor groups. Multivariable logistic regression models evaluated factors associated with positive experience. Two cohorts (220 and 200 patients) met the eligibility criteria for the AOPSS and YVM, respectively. Positive experience was reported similarly between the two PREMs for “overall experience with care”, “discussion of worries”, and “trusting providers with confidential information” with a score difference of 1–4% at the cohort level. Positive experience score difference ranged from 5% to 44% across questions at the tumor group level. Different experience gaps were identified with the two measures, mainly at the tumor group level. Programs interested in using these PREMS might consider this when designing projects.
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Mendlovic, Shlomo, David Roe, Geffen Markusfeld, Jan Mainz, Solvejg Kristensen, and Gil Goldzweig. "Exploring the relation between clinician ratings and patient-reported experience and outcomes." International Journal for Quality in Health Care 34, Supplement_1 (March 31, 2022): ii98—ii104. http://dx.doi.org/10.1093/intqhc/mzac004.
Анотація:
Abstract Background Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly recognized as important ways for patients to be more actively involved in their treatment and enhance shared decision-making. Objective The current study investigated the associations between PROMs, PREMs and various symptoms measures reported by clinicians and psychiatric patients. Method One hundred and twenty people admitted to a psychiatric hospital completed two PREMs, one PROM (the shortened version of the Manchester Short Assessment of Quality of Life scale) and Effects of Symptoms on Daily Functioning (the Sheehan Disability Scale), the Patient Clinical Global Impression and the Modified Colorado Symptom Index. Their psychiatrists rated them using the Global Assessment of Functioning scale, the Health of the Nation Outcome Scales and the Therapist Clinical Global Impression. Results There was a strong correlation between patient’s evaluation of their quality of life (PROM), experience of their care (PREM) and the overall severity of their condition and their progress. The pattern of correlation between patients’ and clinicians’ measures revealed a three-layer structure representing a continuum from inner experience to external presentation of experiences. Conclusion Together these findings help identify and emphasize various domains of subjective experiences and their relation to external ratings.
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De Rosis, Sabina, Francesca Pennucci, Daniel Adrian Lungu, Mario Manca, and Sabina Nuti. "A continuous PREMs and PROMs Observatory for elective hip and knee arthroplasty: study protocol." BMJ Open 11, no. 9 (September 2021): e049826. http://dx.doi.org/10.1136/bmjopen-2021-049826.
Анотація:
IntroductionScholars, healthcare practitioners and policymakers have increasingly focused their attention on patient-centredness. Patient-reported metrics support patient-driven improvement actions in healthcare systems. Despite the great interest, patient-reported outcome measures (PROMs) are still not extensively collected in many countries and not integrated with the collection of patient-reported experience measures (PREMs). This protocol describes the methodology behind an innovative observatory implemented in Tuscany, Italy, aiming at continuously and longitudinally collecting PROMs and PREMs for elective hip and knee total replacement.Methods and analysisThe Observatory is digital. Enrolled patients are invited via SMS or email to online questionnaires, which include the Oxford Hip Score or the Oxford Knee Score. Data are real-time reported to healthcare professionals and managers in a raw format, anonymised and aggregated on a web platform. The data will be used to investigate the relationship between the PROMs trend and patients’ characteristics, surgical procedure, hospital characteristics, and PREMs. Indicators using patient data will be computed, and they will integrate the healthcare performance evaluation system adopted in Tuscany.Ethics and disseminationThe data protection officers of local healthcare organisations and the regional privacy office framed the initiative referring to the national and regional guidelines that regulate patient surveys. The findings will be reported both in real time and for publication in peer-reviewed journals.
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Subbe, Christian Peter, Catherine Atkin, Adnan Gebril, Latif Raiyan Rahman, and Ragit Varia. "Society for Acute Medicine’s Patients: Learning from Experience Report (SAM-PLER) A service evaluation of patient reported experience in Acute Medicine – establishing the feasibility of a quality improvement collaborative." Acute Medicine Journal 22, no. 3 (July 2023): 137–43. http://dx.doi.org/10.52964/amja.0948.
Анотація:
Patient reported experience measures (PREMS) are a key part of measured quality. There is no tool currently used in the UK in Acute Medicine. On the 8th of September 2022 10 units based in England, Scotland and Wales collected data for the validated PREM, alongside the EQ-5D and variables from the Society for Acute Medicine’s Benchmarking Audit (SAMBA) dataset. 365 patients were screened, 200 were included (55%): 159 patients from AMUs and 41 from SDEC units. Overall experience of patients was rated 8.5/10, patients rated their experience of safety, trust and listening highly. Collection of PREMS was feasible. Further research is required to link experience to clinical outcome and explore tools that capture experience of patients with altered mental status.
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Dijk, Nienke, and Anne Kruijsen. "Meting van patiëntenervaringen via PROMs en PREMs." PodoSophia 23, no. 2 (March 2015): 26–27. http://dx.doi.org/10.1007/s12481-015-0035-z.
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Weldring, Theresa, and Sheree M. S. Smith. "Article Commentary: Patient-Reported Outcomes (PROs) and Patient-Reported Outcome Measures (PROMs)." Health Services Insights 6 (January 2013): HSI.S11093. http://dx.doi.org/10.4137/hsi.s11093.
Анотація:
In recent years, there has been an increased focus on placing patients at the center of health care research and evaluating clinical care in order to improve their experience and ensure that research is both robust and of maximum value for the use of medicinal products, therapy, or health services. This paper provides an overview of patients’ involvement in clinical research and service evaluation along with its benefits and limitations. We describe and discuss patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs), including the trends in current research. Both the patient-reported experiences measures (PREMs) and patient and public involvement (PPI) initiative for including patients in the research processes are also outlined. PROs provide reports from patients about their own health, quality of life, or functional status associated with the health care or treatment they have received. PROMs are tools and/or instruments used to report PROs. Patient report experiences through the use of PREMs, such as satisfaction scales, providing insight into the patients’ experience with their care or a health service. There is increasing international attention regarding the use of PREMS as a quality indicator of patient care and safety. This reflects the ongoing health service commitment of involving patients and the public within the wider context of the development and evaluation of health care service delivery and quality improvement.
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Giosa, Justine, Celina Carter, Valentina Cardozo, and Paul Holyoke. "Designing meaningful surveys: Engaging experts-by-lived experience in the development of a patient-reported experience measure (PREM) of integrated home and community care." International Journal of Integrated Care 23, S1 (December 28, 2023): 467. http://dx.doi.org/10.5334/ijic.icic23170.
Анотація:
Background: People want to live well in their homes and communities for as long as possible. To support this, some home care services in Ontario, Canada are restructuring to integrate medical and personal care, with community-based social care and services (e.g., friendly visiting, meals, and transportation). Measures of client experience, referred to as ‘patient-reported experience measures’ (PREMs) are important for guiding health system improvements in a way that is meaningful to clients. A current challenge is that existing PREMS are insufficient for measuring client experience of new models of home and community care.
Aims: This study engaged clients, family/friend caregivers, and health and social care providers in a participatory process to develop relevant items for a PREM for integrated home and community care. This engagement process aimed to provide opportunities for client feedback to support integrated care and ensure the new PREM will collect data that can inform health system improvements in ways that are most meaningful to clients and caregivers.
Methods: Guided by Streiner et al.’s (2015) approach, we engaged experts-by-lived experience in content and face validity testing of an item pool matrix to determine relevance and coverage of domains and items. The matrix consisting of 3 domains, 14 categories, and 72 items was based on a literature review of home and community PREMs (32 PREMs with 550+ items) and interviews with healthcare leader experts (n=6). To conduct content and face validity testing we held three focus groups with home care recipients and family/friend caregivers (n=17) as well as individual interviews with health and social care providers working in home care (n=15). We analyzed transcripts line-by-line to generate themes related to face and content validity of each item.
Results: Participants agreed that client experience of innovative home and community care is well captured by three domains: equity, continuity, and life care. They also agreed the corresponding 72 proposed items had face validity. Suggestions to improve content validity included that items be adapted to recognize the role of caregivers; the role of primary providers and/or coordinators in delivering well organized care; and shifting from a focus on self-management to having needed supports to stay in the home, and collaboratively developing care plans. Participants excluded several items due to being vague or not meaningful, such as asking, “my providers understood my needs”. Based on feedback, 22 items were removed from the matrix.
Learnings: Engaging experts-by-lived experience in development of PREMs helps ensure the data generated from PREMs will be meaningful and useful for guiding health system improvements that matter to clients. Relying on existing literature and traditional expert opinion alone did not guarantee relevance or coverage of items.
Next steps: The feedback from participants will be used to further refine and scale the PREM items. Clients of home care and family/friend caregivers will then be re-engaged in cognitive testing to identify issues related to answering the questions on the scale. Once complete, the PREM will undergo psychometric testing.
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Tsichlaki, Aliki, and Padhraig S. Fleming. "Prioritising patients in research and practice – why and how?" Journal of Orthodontics 46, no. 1_suppl (March 28, 2019): 17–20. http://dx.doi.org/10.1177/1465312519840032.
Анотація:
There is an increasing emphasis on the incorporation of patient reported outcome measures (PROMs) and patient reported experience measures (PREMs) in healthcare. Development, implementation and adoption of these is fundamental in prioritising orthodontic research and practice.
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Caneiras, Cátia, Cristina Jácome, Sagrario Mayoralas-Alises, José Ramon Calvo, João Almeida Fonseca, Joan Escarrabill, and João Carlos Winck. "Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go." Journal of Clinical Medicine 8, no. 4 (April 24, 2019): 555. http://dx.doi.org/10.3390/jcm8040555.
Анотація:
The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.
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Jansen, L., F. Glowacz, A. Kinard, and R. Bruffaerts. "How to Integrate Patient-Centered Measures in Routine Care: Lessons from Belgian Experiences." European Psychiatry 65, S1 (June 2022): S17. http://dx.doi.org/10.1192/j.eurpsy.2022.68.
Анотація:
BACKGROUND Against the treatment gap and the long delays in seeking treatment for mental health problems, primary care psychology (PCP) was added to reimbursed outpatient mental health services in the Belgian healthcare system. PURPOSE Within the Evaluation of Primary Care Psychology study (EPCAP), which provides evaluation of the measure of reimbursement of PCP, the objectives were: (1) To describe the patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) of patients treated with PCP and (2) formulate guidelines to integrate patient-related findings and experiences within community mental health services. METHOD 428 patients participated in an online survey at the start of their PCP treatment in Belgium and after 3 and 6 months. Besides sociodemographic characteristics, DSM-5 mental disorders, suicidality, and service use, they were questioned about their findings (PROMs) and experiences (PREMs). RESULTS Almost 90% met the criteria of a lifetime as a 12-month DSM-5 mental disorder or STB at the start of PCP treatment. Both subjective well-being and the proportion of patients who had positive experiences regarding their PCP treatment increased with 46% resp. 23.2% after 3 months and remained stable after 6 months. CONCLUSION Although PCP in Belgium serves a clinical patient population with high proportions of lifetime and 12-month mental disorders and suicidality, their subjective well-being increased after 3 months and remained stable after 6 months. Despite differences between groups of patients, PCP seems to have a positive effect on subjective well-being of these patient in short term. Integration of PROMs and PREMs into PCP were recommended. Disclosure No significant relationships.
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Benson, Tim. "Measure what we want: a taxonomy of short generic person-reported outcome and experience measures (PROMs and PREMs)." BMJ Open Quality 9, no. 1 (March 2020): e000789. http://dx.doi.org/10.1136/bmjoq-2019-000789.
Анотація:
IntroductionHealth and care systems are complex and multifaceted, but most person-reported outcome and experience measures (PROMs and PREMs) address just one aspect. Multiple aspects need measuring to understand how what we do impacts patients, staff and services, and how these are affected by external factors. This needs survey tools that measure what people want, are valid, sensitive, quick and easy to use, and suitable for people with multiple conditions.MethodsWe have developed a coherent family of short generic PROMs and PREMs that can be used in combination in a pick-and-mix way. Each measure has evolved iteratively over several years, based on literature review, user inputs and field testing. Each has has a common format with four items with four response options and is designed for digital data collection with standardised analytics and data visualisation tools. We focused on brevity and low reading age.ResultsThe results are presented in tabular format and as a taxonomy. The taxonomy is categorised by respondent type (patient or staff) and measure type. PROMs have subdomains: quality of life, individual care and community; PREMs have subdomains: service provided, provider culture and innovation. We show 22 patient-reported measures and 17 staff-reported measures. Previously published measures have been validated. Others are described for the first time.Discussion and conclusionsThis family of measures is broad in scope but is not claimed to be comprehensive. Measures share a common look and feel, which enables common methods of data collection, reporting and data visualisation. They are used in service evaluation, quality improvement and as key performance indicators. The taxonomy helps to organise the whole, explain what each measure does and identify gaps and overlaps.
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Gore, C., R. Griffin, T. Rothenberg, A. Tallett, B. Hopwood, S. Sizmur, C. O'Keeffe, and J. O. Warner. "New patient-reported experience measure for children with allergic disease: development, validation and results from integrated care." Archives of Disease in Childhood 101, no. 10 (August 2, 2016): 935–43. http://dx.doi.org/10.1136/archdischild-2015-309598.
Анотація:
ObjectivesTo develop and validate a new allergy-specific patient-reported experience measure (PREM) for children and their parents, and to collect feedback in an integrated care setting.DesignTwo allergy-specific PREMs were produced using focus groups, cognitive testing, two prospective validation studies (collaboration: Royal College of Paediatrics and Child Health, Picker Institute Europe, Imperial College/London): ‘Your Allergy Care’, for children aged 8–16 years; ‘Your Child's Allergy Care’, for parents of children aged 0–7 years.SettingCommunity event, primary/secondary/tertiary allergy care settings.Main outcome measuresPerformance of PREMs in validation study; reported experience of allergy care.Participants687 children with allergic conditions and their parents/carers.ResultsIn total, 687 questionnaires were completed; 503/687 (253 child; 250 parent) for the final survey. In both surveys, demographic variations were not associated with differences in results. Although 71% of patients reported one or more allergic conditions (food allergy/eczema/hay fever/asthma), 62% required multiple visits before receiving final diagnosis. Overall, patient experience was good for communication with patient/parent, competence and confidence in ability, and 73% felt looked after ‘very well’ and 23% ‘quite well’. Areas for improvement included communication with nurseries/schools, more information on side effects, allergic conditions and allergen/irritant avoidance. Allergy care in primary/emergency care settings was associated with higher problem-scores (worse experience) than in specialist clinics.ConclusionsThese new PREMs will allow allergy-specific patient experience reporting for children and parents and help identification of priority areas for improvement and commissioning of care. Efforts towards better allergy care provision must be targeted at primary and emergency care settings and underpinned by improving communication between healthcare providers and the community.
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Kostuj, Tanja, and Anna Niemeyer. "Diagnostik und Therapie aus der Patientenperspektive - PROMs in der Chirurgie." Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie 147, no. 02 (April 2022): 125–28. http://dx.doi.org/10.1055/a-1213-0817.
Анотація:
Zusammenfassung/AbstractDie zunehmend an Bedeutung gewinnenden Patient reported Outcome and Experience Measures (PROMs/PREMs) können in allen chirurgischen Disziplinen zusätzlich zu den klassischen harten Endpunkten wie z. B. Überlebenskurven und Implantatestandzeiten wichtige Informationen zu Qualitätsindikatoren oder Entscheidungshilfen zu konkurrierenden Therapieverfahren liefern. Dies gilt ebenso für die Evaluation neuer Therapiekonzepte wie für Vergleiche klassisch offener Zugangswege und minimalinvasiver bzw. endoskopischer Verfahren z. B. im Hinblick auf geringere Zugangsmorbidität und schnellere Rehabilitation vs. höherem Komplikationsrisiko, aber auch der Risiko-Nutzen-Bewertung der Verlängerung der Lebenszeit einerseits auf Kosten einer Beeinträchtigung der Lebensqualität andererseits.Diesem Zusatznutzen steht ein notwendiger Ressourceneinsatz (Personal- und Sachkosten für Postversand oder für eine Onlineerhebung in Form von Entwicklungs-, Bereitstellungs- oder Lizenz- und Servicekosten) gegenüber, der sich nur bedingt beeinflussen lässt (z. B. Portokosten für eine Vollerhebung vs. repräsentative Stichprobe). Die zentrale Voraussetzung für den erfolgreichen Einsatz von PROMs und PREMs ist jedoch, dass geeignete, sprachlich und inhaltlich validierte Erhebungsinstrumente verfügbar sind oder durch einen Validierungsprozess zur Verfügung gestellt werden können.Für den Einsatz von PROMs bei konkurrierenden Therapieansätzen findet sich bereits eine Reihe von Beispielen, die wertvolle Unterstützung bieten und sich im Klinikalltag etabliert haben. So können sie bei belastenden Therapieansätze in der chirurgischen Tumortherapie bei Entscheidungen über ein verbessertes Überleben bei starker Belastung vs. dem Erhalt oder sogar Zugewinn an Lebensqualität unterstützen. In der onkologischen Mammachirurgie steht die Lebensqualität bei brusterhaltendem Vorgehen häufig der Überlebenszeit bezogen auf das TU-Stadium bei Ablation gegenüber. Ebenso gilt es bei Prostatakarzinompatienten, immer wieder zwischen invasiver Therapie und Verlaufsbeobachtung (Überleben vs. Inkontinenz und Potenzstörungen) zu entscheiden. In der Orthopädie/Unfallchirurgie gibt es bei einer Reihe von Eingriffen häufig eine Alternative, z. B. Sprunggelenkendoprothesen vs. Arthrodesen oder inverse Schulterprothesen vs. Osteosynthese bei schultergelenknahen Humerusfrakturen.Aber auch bei der Evaluation neuer Therapiekonzepte (z. B. der subjektive Aspekt einer früheren Wiedererlangung der Selbstständigkeit durch Einführung neuer Nachbehandlungskonzepte/sog. Fast-Track-Reha) sind PROMs und PREMS wichtige Werkzeuge.
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Moody, Lesley, Suman Dhanju, Sarah Benn, Isabela Olaru, Nadia Sliz, Amy Snow, Sara Khan, and Simron Singh. "Systematically implementing an electronic platform to improve patient experience measurement in Ontario, Canada." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 111. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.111.
Анотація:
111 Background: Cancer Care Ontario organizes and ensures quality cancer care for 13.5 million residents in Ontario, Canada and is systematically deploying a web-based tool, called Electronic Patient Reported Experience Measures (ePREM), through a touch-screen platform previously deployed within Regional Cancer Centres (RCCs). ePREM has been used to disseminate the first patient reported experience measure (PREM), called Your Voice Matters (YVM). YVM will be collected on all patients in Ontario undergoing cancer treatment in real time, creating the largest known, linkable patient experience dataset. Methods: Implementation feasibility and readiness was assessed across all 14 Regional Cancer Programs through a provincial assessment which informed the phased implementation. Implementation was rooted in a change management framework: clinical and administrative champions, available resources, existing technical environment and competing program priorities. In March 2016 a four-wave implementation was initiated controlling for readiness and centre volumes, with a focus on extensive stakeholder engagement, tool training, launch and operational support. To date, ePREM is fully operational in 10 of 15 RCCs. Results: Provincial deployment was 66% complete in October 2016. By March 2017 full provincial implementation will be complete. Successful implementation has been directly linked to an adaptive design within the implementation and change management framework as a four-wave roll out. Key factors included: multi-faceted communications with centre leadership, and implementation teams. During this initial data stabilization phase, there were 9,266 completed surveys submitted and 10,932 partial survey responses submitted. Conclusions: PREMs are appropriate quality improvement indicators for cancer patients within the treatment phase. ePREMs enables systematic, linkable collection of real time PREMs to improve the patient experience in Ontario and contribute to the planning of new initiatives. Upon full provincial implementation ePREMs will allow for the largest known dataset of PREMs. Successful implementation has been directly linked to an adaptive, four-wave approach.
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Bargeri, Silvia, Greta Castellini, Jacopo Antonino Vitale, Stefania Guida, Giuseppe Banfi, Silvia Gianola, and Federico Pennestrì. "Effectiveness of Telemedicine for Musculoskeletal Disorders: Umbrella Review." Journal of Medical Internet Research 26 (February 2, 2024): e50090. http://dx.doi.org/10.2196/50090.
Анотація:
Background Several systematic reviews (SRs) assessing the use of telemedicine for musculoskeletal conditions have been published in recent years. However, the landscape of evidence on multiple clinical outcomes remains unclear. Objective We aimed to summarize the available evidence from SRs on telemedicine for musculoskeletal disorders. Methods We conducted an umbrella review of SRs with and without meta-analysis by searching PubMed and EMBASE up to July 25, 2022, for SRs of randomized controlled trials assessing telemedicine. We collected any kind of patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs), and objective measures, including direct and indirect costs. We assessed the methodological quality with the AMSTAR 2 tool (A Measurement Tool to Assess systematic Reviews 2). Findings were reported qualitatively. Results Overall, 35 SRs published between 2015 and 2022 were included. Most reviews (n=24, 69%) were rated as critically low quality by AMSTAR 2. The majority of reviews assessed “telerehabilitation” (n=29) in patients with osteoarthritis (n=13) using PROMs (n=142 outcomes mapped with n=60 meta-analyses). A substantive body of evidence from meta-analyses found telemedicine to be beneficial or equal in terms of PROMs compared to conventional care (n=57 meta-analyses). Meta-analyses showed no differences between groups in PREMs (n=4), while objectives measures (ie, “physical function”) were mainly in favor of telemedicine or showed no difference (9/13). All SRs showed notably lower costs for telemedicine compared to in-person visits. Conclusions Telemedicine can provide more accessible health care with noninferior results for various clinical outcomes in comparison with conventional care. The assessment of telemedicine is largely represented by PROMs, with some gaps for PREMs, objective measures, and costs. Trial Registration PROSPERO CRD42022347366; https://osf.io/pxedm/
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Zrubka, Zsombor, Óscar Brito Fernandes, Petra Baji, Ottó Hajdu, Levente Kovacs, Dionne Kringos, Niek Klazinga, et al. "Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study." Journal of Medical Internet Research 22, no. 8 (August 11, 2020): e19013. http://dx.doi.org/10.2196/19013.
Анотація:
Background Digital health, which encompasses the use of information and communications technology in support of health, is a key driving force behind the cultural transformation of medicine toward people-centeredness. Thus, eHealth literacy, assisted by innovative digital health solutions, may support better experiences of care. Objective The purpose of this study is to explore the relationship between eHealth literacy and patient-reported experience measures (PREMs) among users of outpatient care in Hungary. Methods In early 2019, we conducted a cross-sectional survey on a large representative online sample recruited from the Hungarian general population. eHealth literacy was measured with the eHealth Literacy Scale (eHEALS). PREMs with outpatient care were measured with a set of questions recommended by the Organisation for Economic Co-operation and Development (OECD) for respondents who attended outpatient visit within 12 months preceding the survey. Bivariate relationships were explored via polychoric correlation, the Kruskal–Wallis test, and chi-square test. To capture nonlinear associations, after controlling covariates, we analyzed the relationship between eHEALS quartiles and PREMs using multivariate probit, ordinary least squares, ordered logit, and logistic regression models. Results From 1000 survey respondents, 666 individuals (364 females, 54.7%) were included in the study with mean age of 48.9 (SD 17.6) years and mean eHEALS score of 29.3 (SD 4.9). Respondents with higher eHEALS scores were more likely to understand the health care professionals’ (HCPs’) explanations (χ29=24.2, P=.002) and to be involved in decision making about care and treatment (χ29=18.2, P=.03). In multivariate regression, respondents with lowest (first quartile) and moderately high (third quartile) eHEALS scores differed significantly, where the latter were more likely to have an overall positive experience (P=.02) and experience fewer problems (P=.02). In addition, those respondents had better experiences in terms of how easy it was to understand the HCPs’ explanations (P<.001) and being able to ask questions during their last consultation (P=.04). Patient-reported experiences of individuals with highest (fourth quartile) and lowest (first quartile) eHEALS levels did not differ significantly in any items of the PREM instrument, and neither did composite PREM scores generated from the PREM items (P>.05 in all models). Conclusions We demonstrated the association between eHealth literacy and PREMs. The potential patient-, physician-, and system-related factors explaining the negative experiences among people with highest levels of eHealth literacy warrant further investigation, which may contribute to the development of efficient eHealth literacy interventions. Further research is needed to establish causal relationship between eHealth literacy and patient-reported experiences.
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Hodson, M., S. Andrew, and C. Michael Roberts. "Towards an understanding of PREMS and PROMS in COPD." Breathe 9, no. 5 (September 1, 2013): 358–64. http://dx.doi.org/10.1183/20734735.006813.
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Scholz, Maria, Rocco Haase, Katrin Trentzsch, Heidi Stölzer-Hutsch, and Tjalf Ziemssen. "Improving Digital Patient Care: Lessons Learned from Patient-Reported and Expert-Reported Experience Measures for the Clinical Practice of Multidimensional Walking Assessment." Brain Sciences 11, no. 6 (June 14, 2021): 786. http://dx.doi.org/10.3390/brainsci11060786.
Анотація:
Background: Walking assessment (WA) enables meaningful patient mobility assessment. In this context, patient satisfaction with WA can influence assessment compliance and indirectly affect outcomes. One opportunity to assess patient satisfaction is patient-reported and expert-reported experience measures (PREM). Research on PREMs and WA in daily clinical multiple sclerosis (MS) practice does not exist yet. Methods: We surveyed people with MS about their experience and assessed healthcare professionals’ experience via an interview after patients completed WA. Results: Gait parameters were related to perceived difficulty and strain during performance. Less impaired patients perceived the WA to be less difficult and exhausting but were less likely to use WA results for themselves. Men and patients with higher impairment would perform WA more frequently. A good workflow, a fully performed WA with standardized testing, fully functional measurement systems, support and safeguarding by staff in case of falls, direct feedback after the testing, and patients’ motivation are identified by the experts as necessary factors for a successful WA. Conclusions: As patients’ experience has an impact on patients’ outcomes, long-term monitoring of PREMs should become an integral part of the healthcare service to identify and avoid problems early.
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Sočan, Gregor, Dolf De Boer, Eva Murko, Marcel Kralj, Nina Ropret, and Metka Zaletel. "Psychometric Validation of an Instrument for Measuring Patient Experiences with Outpatient Healthcare." Slovenian Journal of Public Health 62, no. 3 (June 13, 2023): 153–61. http://dx.doi.org/10.2478/sjph-2023-0021.
Анотація:
Abstract Aim Recently, a patient-reported experience measure (PREM) was developed in Slovenia to assess patients’ experiences with outpatient specialist healthcare clinics. The aim of this study was to evaluate the psychometric properties (including factor structure, reliability, convergent validity, and response distribution) of the questionnaire. Methods The sample consisted of 8,406 adult participants treated in 171 specialist clinics from different medical fields. Participants voluntarily and anonymously responded to either the paper or online survey. Results Descriptive statistics show meaningful response patterns with a general tendency towards favourable assessments. The psychometric analyses of the scales evaluating doctor’s and nurses’ work, respectively, generally showed a good fit of the unidimensional factor model as well as the Rasch model, high factor loadings and very good to satisfactory reliability. The Rasch scaling showed that these scales were most informative for patients with relatively unfavourable experience ratings. Conclusions The results are similar to those found in previous evaluations of PREMs in other countries. Given its good psychometric properties, the Slovenian PREM can be recommended for healthcare evaluations in Slovenia and as a model for the development of similar PREMs in other countries.
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Slade, M. "Personal recovery, clinical recovery and patient-rated measures." European Psychiatry 66, S1 (March 2023): S35. http://dx.doi.org/10.1192/j.eurpsy.2023.135.
Анотація:
AbstractThis talk will cover two common areas of confusion. First, the relationship between personal recovery and clinical recovery will be described, using recent meta-analytic evidence. It will be argued that personal recovery is not the same as clinical recovery, and that there is now an established policy and practice consensus that supporting personal recovery is the primary aim of mental health systems. Traditional clinical recovery-oriented treatments which target for example symptomatology or relapse prevention can for many people with mental health issues contribute to their recovery at points in their lives, but for others different approaches are needed. This variation in clinical need is addressed in the second area – patient-rated measures. The rationale for measures of experiential knowledge will be given. A distinction will be drawn between Patient-rated outcome measures (PROMs) and Patient-rated experience measures (PREMs), and between peer-developed patient-generated PROMs (PG-PROMs) compared with those developed by non-peer research teams. It will be argued that modern mental health systems should be judged by their impact on recovery, as measured using PROMs and PREMs in preference to staff-rated measures.Disclosure of InterestNone Declared
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Webber, Kate, Olivia Cook, Michelle White, Alastair Kwok, and Eva Segelov. "The impact of the COVID-19 pandemic on patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in an Australian outpatient oncology setting." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 195. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.195.
Анотація:
195 Background: PROMs and PREMs may be useful tools to reflect the impact of the COVID-19 pandemic on cancer patients’ wellbeing and care. This analysis compares baseline self-reported quality of life (QoL), symptoms and supportive care needs between two independent patient groups based on when and how they attended their oncology appointment: 1) in person, prior to the global declaration of the COVID-19 pandemic and; 2) via telehealth, during the pandemic. Methods: Patients were invited to complete a suite of PROMs and PREMs including the EQ-5D-5L, modified Edmonton Symptom Assessment System-Revised (ESAS-R) and the modified Supportive Care Needs Survey Short-Form (SCNS-SF34) on an iPad in the waiting room before each appointment (pre-COVID-19 pandemic phase, December 2019 to March 2020) or online prior to a telehealth appointment (COVID-19 pandemic phase, October 2020 to April 2021). Descriptive statistics were reported for clinical and demographic factors and the PROMs and PREMs. Baseline scores from pre-COVID-19 and COVID-19 cohorts were compared using t-tests and chi-square tests. Results: In the pre-COVID-19 phase, 100 patients (99 females, 60.7 years old) participated compared with 129 patients (128 females, 59.7 years old) in the COVID-19 phase. Primary cancer diagnoses were breast (pre-COVID-19 68%, COVID-19 71%), gynaecological (pre-COVID-19 31%, COVID-19 37%) and lung (pre-COVID-19 1%) cancers. Mean age, gender, relationship status, language spoken, cancer diagnoses, and staging were similar, all p > 0.05. Median self-rated health (EQ-VAS score) was also similar between the pre-COVID-19 phase (74, IQR 33) and the COVID-19 phase (75, IQR 34), p = 0.51. Median ESAS-R swelling/lymphoedema score was higher for the COVID-19 phase (1, IQR 3) than the pre-COVID-19 phase (0, IQR 3), p = 0.03. Median SCNS standardised psychological domain score was lower for the COVID-19 phase (35, IQR 40) compared with the pre-COVID-19 phase (45, IQR 42), p = 0.03. No other significant differences in symptoms or unmet needs were noted (all p > 0.05). The top three symptoms concerns (ESAS-R score ≥7) were: 1) tiredness (pre-COVID-19 33%, COVID-19 22.7%); 2) sleep problems (pre-COVID-19 24.5%, COVID-19 21.9%); 3) drowsiness (pre-COVID-19 21.2%) and concentration and memory (COVID-19 19.5%). Conclusions: Despite the COVID-19 pandemic, these data reflect the symptoms and concerns impacting on the QoL among Australian oncology patients have remained largely stable. Although Australian COVID-19 case numbers have remained low, PROMs and PREMs are crucial tools for continuing to support oncology patients with QoL and supportive needs in the pandemic era. Clinical trial information: ACTRN12619001470189.
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van Overveld, Lydia Francisca Jacoba, Robert P. Takes, Jozé C. C. Braspenning, Ludi E. Smeele, Matthias A. W. Merkx, and Rosella P. M. G. Hermens. "PROMs and PREMs in Dutch integrated head and neck cancer care: Measurements and evaluation." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 209. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.209.
Анотація:
209 Background: Providing patient-centred care is an essential component of high quality integrated care. Nowadays, patient reported outcomes and experiences are increasingly used to measure quality of care. As part of a quality registration, the Dutch Head and Neck Audit, patient reported outcomes (PROs) and experiences (PREs) of patients with head and neck cancer (HNC) are measured with questionnaires and evaluated to increase patient-centred care. Methods: Patientswere recruited from nine hospitals participating in the DHNA. Validated questionnaires were distributed at baseline, 3, 6 and 12 months follow-up. Included PROMs were EQ-5D-3L, EORTC QLQ-C30 and EORTC QLQ-H&N35. Included PREMs were Consumer Quality index for Oncologic care (CQO) and Radiotherapeutic care (CQR). CQO and CQR have similar domains with different questions. With descriptive analysis, ANOVA and mixed model analysis, differences over time and between treatment groups were analyzed. Results: Questionnaires were filled in by 238 patients. Pain decreased significantly at 6 and 12 months follow-up and dry mouth increased significantly at 3, 6 and 12 months follow-up compared to baseline. Sticky Salvia, problems with social eating and sense problems increased at 3 and 6 months follow-up, but were similar to the baseline score at 12 months follow-up. Pain and sticky saliva differed between radiotherapy and chemoradiotherapy or surgery and radiotherapy respectively (p ≤ 0.05). Regarding the CQO domain scores, all treatment groups differ significantly from each other (p ≤ 0.05). This was not regarding the CQR domain scores. Except for the domain Organisation, no differences between the CQO and CQR domain scores were found. Recognizing the emotional side of HNC (care) and intensifying guidance after the treatment period needs improvement. Conclusions: This study gives clues to improve healthcare according the experiences of the patient and we can predict more carefully the outcomes of the patients with different treatment types. PROMs according to the ICHOM criteria and PREMs are promising for measuring and improving quality and personalization of HNC care. However, the usage of two PREMs had no added value to evaluate and address points of improvement.
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Hermens, Rosella, Lydia Francisca Jacoba van Overveld, Robert P. Takes, Jozé C. C. Braspenning, Ludi E. Smeele, and Matthias A. W. Merkx. "PROMs and PREMs in Dutch integrated head and neck cancer care." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 6570. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.6570.
Анотація:
6570 Background: Providing patient-centred care is an essential component of high quality integrated care. A method to get insight in patients perspectives about the quality of health care they received, is measuring Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs). We aimed to determine the outcomes of, and differences between PROs and PREs over time and between treatment groups for patients with head and neck cancer (HNC). Methods: Patientswere recruited from nine hospitals participating in the DHNA. Validated questionnaires were distributed at baseline, 3, 6 and 12 months follow-up. Included PROMs were EuroQol 5 Dimension 3 Level (EQ-5D-3L), EORTC QLQ-C30 and -H&N35. Included PREMs, Consumer Quality index for Oncologic care (CQO) and Radiotherapeutic care (CQR), have similar domains with different questions. With descriptive analysis, ANOVA and mixed model analysis, differences over time and between treatment groups were analyzed. Results: Questionnaires were filled in by 426 patients. Pain decreased significantly at 6 and 12 months follow-up (14 and 21 points on a scale of 0-100) and dry mouth increased significantly at 3, 6 and 12 months follow-up compared to baseline (35, 27 and 20 points). Sticky Salvia, problems with social eating and sense problems increased at 3 and 6 months follow-up, but were similar to the baseline score at 12 months follow-up. Pain and sticky saliva differed between radiotherapy and chemoradiotherapy or surgery and radiotherapy respectively (p≤0.05). Regarding the CQO domain scores, all treatment groups differed significantly from each other (p≤0.05), especially for the domain Personal input. There was no difference regarding the CQR domain scores. Recognizing the emotional side of HNC and guidance after the treatment scored low in patients. Conclusions: This study gives clues to improve healthcare according the experiences of the patient and we can predict more carefully the outcomes of the patients with different treatment types. PROMs according to the ICHOM criteria and PREMs are promising for measuring and improving quality and personalization of HNC care. However, recognizing the emotional side of HNC and intensifying guidance after the treatment period needs improvement.
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Almeida, Rosa, Diana Filipa Marques, Raquel Losada Durán, Yolanda Bueno Aguado, Teresa Cid-Bartolomé, Silvia González-González, and Magda Hatzikou. "A game changer Joint Design Journey of PREMS and PROMS in the HOSMARTAI virtual coach study." International Journal of Integrated Care 23, S1 (December 28, 2023): 659. http://dx.doi.org/10.5334/ijic.icic23586.
Анотація:
Background: HosmartAI, “Hospital Smart development based on AI” (H2020, GA.101016834), stands for effective and efficient healthcare system transformation creating a common open integration platform offering multifaceted lasting functionalities (e.g. Marketplace, Co-creation space, Benchmarking tool) to healthcare stakeholders. This platform will allow the collection and analysis of highly relevant datasets to support decision-making. For validating the concept and AI platform, the project includes 8 Lighthouse Pilots, between them, a complementary system aimed to support older adults in their homes or in clinical centres to perform training, prevention and rehabilitation activities. In this sense, appropriate quality measures and methods are fundamental for a continuous improvement of care services. However, the use of PREMs in a continuous and systematic way portrays a recent and still scarcely implemented approach.
Objective: This case study presents the process that led to the participatory definition of the productivity, efficiency and quality measures for the HosmartAI virtual assistant for a continuity of care in neuropsychological rehabilitation and elderly care.
Methods: The HOSMARTAI co-creation methodology focused on exploring the care journey through two initial cycles involving 24 participants to empathize, define collaboratively user requirements and ideate the solution use paths. In the process was included the selection and adjustment of the most valuable assessment indicators with a double goal to validate the approach in a pilot study and of value for the different parts (patients, therapists, healthcare services managers).
Results/Discussion: The process contributes to meet the end-users’ demands. Firstly, the co-creation process allowed deepening the understanding of the context, the health system and the challenges perceived by people in the primary-user condition, to identify significant concepts of interest for the response, and to reach an appropriate direction, taking into account the patients key points of interest. It was the base to define collaboratively an assessment protocol for the proposed system to address the commented challenges, with a key focus on the Patient Reported Experience which data has the potential to narrow the gap between the therapists’ and patients’ views and help tailor treatment plans to meet the patients’ preferences and needs. The resulting assessment protocol ensure a combination of suitable set of PROMs and PREMs, where PREMs capture in detail the patients’ experience perception with the technology and the service(s) offered through it. From the key considerations, ensuring a soft evaluation approach including data collected throughout seamless interactions with the service interfaces (tablet and social robot) at appropriate moments of the interventions that are complemented with easy to answer questionnaires and semi-structured interviews, ensuring an assessment approach to the patient so natural, intuitive and pleasant as possible.
Conclusions: This work contributes to the solution development, validation and standardisation, enabling the delivery of high quality care from the perspective of the different stakeholders with a special focus on the end-users. This research continues collecting lessons learnt from the process, such as the need to adopt a flexible co-design framework with stakeholders (including primary and secondary users) and open to regular adjustment/revision of PREMs and PROMs on these highly changing contexts.
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Pennucci, Francesca. "Patient-reported measures for integrated care assessment: interprofessional collaboration, self-care and outcomes." International Journal of Integrated Care 23, S1 (December 28, 2023): 666. http://dx.doi.org/10.5334/ijic.icic23590.
Анотація:
Chronicity is spreading and rapidly becoming a urgent issue also for the complexity of care. 32.2 million of NCD deaths (80%) are due to chronic diseases (1). Every country has been developing strategies to guarantee assistance to chronic patients while ensuring the sustainability of the system. Interprofessional collaboration is among the features to improve the assistance for chronic patients and to reach coordination, appropriateness, and continuity along the care pathways (2,3). Data collection on this topic is still scarce, especially from the point of view of patients themselves. Patient Reported Outcome and Experience Measures (PROMs and PREMs) collected in an integrated way can help in understanding the relationship of experience and outcome along the patient care pathway, thus providing a complete vision of the quality and integration of care from the patient perspective (4).
This work aims at reporting some preliminary results about the impact of interprofessional collaboration on the health outcomes and self-care capacity of chronic heart failure (CHF) patients.
Data from the Observatory on PROMs and PREMs of the Tuscany Region in Italy will be used to explore the hypothesis that interprofessional collaboration can lead to better self-care and outcome scores as reported by patients. The selected sample replied to four questionnaires: one at discharge by the hospital, a first follow-up after 30 days; a second follow-up after 7 months; a final follow-up after 12 months (5). Average scores and deltas for the KCCQ-12 and the SCHFI scales will be used to detect potential differences between patients’ self-care, health status and quality of care according to the reported level of integration between the general practitioner and the specialist.
132 responses were valid to be analysed. At baseline, 23% of patients declared that their GP and their specialist were in contact to take care of the care pathway, 15% declared they did not know. Differences between scores are not significant for the KCCQ-12 on health status and quality of life. A weak difference emerged for the Self-care Maintenance about daily lifestyle adherence.
Further research should be conducted on this topic to understand if these results are linked to a scarce knowledge of patients with respect to the joint work of GPs and specialists or if the interprofessional collaboration is not sufficient to guarantee an improvement of outcomes, at least for CHF patients. Indeed, the same analyses could be repeated on other two chronic populations (e.g. diabetic and IBD patients) which are providing their data that will be available next year.
1.2018. “NCD Countdown 2030: Worldwide Trends in NCD Mortality and Progress towards Sustainable Development Goal Target 3.4.” Lancet
2.Pascucci2021. “Impact of Interprofessional Collaboration on Chronic Disease Management.” Health Policy
3.Davidson2022. “What Do Patients Experience? Interprofessional Collaborative Practice for Chronic Conditions in Primary Care” BMC Primary Care
4.Pennucci“Can the Jointly Collection of PROMs and PREMs Improve Integrated Care?” IJIC
5.Pennucci“Piloting a Web-Based Systematic Collection and Reporting of PROMs/PREMs in Chronic Heart Failure.” BMJ Open
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Palmer, RI, KL Withers, and G. Carolan-Rees. "Patient Outcomes In Wales: The Proms, Prems & Effectiveness Programme (PPEP)." Value in Health 20, no. 9 (October 2017): A686. http://dx.doi.org/10.1016/j.jval.2017.08.1733.
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Scanferla, E., and P. Gorwood. "The Value and Challenges of Implementing Patient Centered Measures in a Psychiatric Hospital Setting." European Psychiatry 65, S1 (June 2022): S17. http://dx.doi.org/10.1192/j.eurpsy.2022.69.
Анотація:
Background: Measuring and interpreting outcome is challenging in mental health services than in some other areas of health care. Objectives: The aims of this study were to (1) explore results of Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) in psychiatric hospital settings, (2) describe the relation between generic PROMs (measure of well-being) and specific PROMs (disorder-specific symptom assessments), (3) describe the congruence between patients and clinicians evaluation of the care experience (based on Patients reported experience measures and Clinician reported experience measures). Methods: A total of 269 consecutive patients participated in this study. Results: (1) Subjective experience of well-being (outcome) improved after hospitalisation (+15%, avg). High satisfaction with subjective experience of care (85%, avg). (2) Significant correlation between patients’ assessment of subjective well-being (generic PROMs) and clinical improvement (specific PROMs) (p <0.007). (3) Significant correlation between patient and clinician experience of care (p= 0.002). Conclusions: One of the first French studies on the use of standardised PROMs and PREMs in psychiatric hospital settings. Results suggest that subjective well-being measures complement the assessment of the patient’s clinical symptoms and social functioning. The effectiveness of care depends on the consideration of these three dimensions. The use of core patient-reported measures, as part of systematic measurement and performance monitoring in mental health care, provides valuable input to the clinicians’ practice. Disclosure No significant relationships.
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Neilson, Laura J., Joanne Patterson, Christian von Wagner, Paul Hewitson, Lesley M. McGregor, Linda Sharp, and Colin J. Rees. "Patient experience of gastrointestinal endoscopy: informing the development of the Newcastle ENDOPREM™." Frontline Gastroenterology 11, no. 3 (January 13, 2020): 209–17. http://dx.doi.org/10.1136/flgastro-2019-101321.
Анотація:
BackgroundMeasuring patient experience is important for evaluating the quality of patient care, identifying aspects requiring improvement and optimising patient outcomes. Patient Reported Experience Measures (PREMs) should, ideally, be patient derived, however no such PREMs for gastrointestinal (GI) endoscopy exist. This study explored the experiences of patients undergoing GI endoscopy and CT colonography (CTC) in order to: identify aspects of care important to them; determine whether the same themes are relevant across investigative modalities; develop the framework for a GI endoscopy PREM.MethodsPatients aged ≥18 years who had undergone oesophagogastroduodenoscopy (OGD), colonoscopy or CTC for symptoms or surveillance (but not within the national bowel cancer screening programme) in one hospital were invited to participate in semi-structured interviews. Recruitment continued until data saturation. Inductive thematic analysis was undertaken.Results35 patients were interviewed (15 OGD, 10 colonoscopy, 10 CTC). Most patients described their experience chronologically, and five ‘procedural stages’ were evident: before attending for the test; preparing for the test; at the hospital, before the test; during the test; after the test. Six themes were identified: anxiety; expectations; choice & control; communication & information; comfort; embarrassment & dignity. These were present for all three procedures but not all procedure stages. Some themes were inter-related (eg, expectations & anxiety; communication & anxiety).ConclusionWe identified six key themes encapsulating patient experience of GI procedures and these themes were evident for all procedures and across multiple procedure stages. These findings will be used to inform the development of the Newcastle ENDOPREM™.
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Ažukaitis, Karolis, Roma Puronaitė, Goda Elizabeta Vaitkevičienė, Justas Trinkūnas, Augustina Jankauskienė, and Danguolė Jankauskienė. "Integrated Collection of Patient-Reported Outcomes and Experiences in Children with Kidney and Hematological Diseases: A Pilot Study." Children 10, no. 7 (July 19, 2023): 1245. http://dx.doi.org/10.3390/children10071245.
Анотація:
We aimed to explore the feasibility and potential relevance of integrated electronic collection of patient-reported outcome and experience measures (PROM and PREM) in children with special healthcare needs (CSHCN) by using the example of children with kidney and hematological diseases. We performed a cross-sectional, single-center study of children <18 years of age. Children (≥10 years) and their parents received Generic PedsQL Core Scale 4.0 and custom PREM surveys to their email addresses via the REDCap platform, and the results were integrated into the hospital’s electronic health records system. A total of 192 patients (98 with kidney diseases and 94 with hematological diseases) were enrolled. The overall response rate was 51%, and the median time for completion of each proxy questionnaire was approximately three minutes. The lowest PROM scores were observed in the emotional and school functioning dimensions. More favorable experiences in the diagnosis establishment process were associated with higher scores in physical, social, school functioning, and total PROM scores. A better evaluation of the hospital’s environment was associated with higher social functioning, while better information provision correlated with higher physical functioning and total PROM scores. Our data indicates that integrated electronic collection of PROMs and PREMs in the population of CSHCN is feasible, but efforts to increase the response rate are needed. The associations between PROMs and PREMs suggest that future studies exploring targeted interventions at the healthcare service level to improve subjective patient outcomes are needed.