Framework to assess the effects of using patient-reported outcome measures in chronic care management
- 1.5k Downloads
The inclusion of patient-reported outcome measures (PROMs) in the routine clinical care of chronically ill patients has the potential to add valuable information about the impact of the disease and its treatment and promotes effective patient self-management in which patients become more active participants in their own care. PROMs provide clinicians with timely information on patients’ symptoms as well as functional and emotional status. PROMs are a useful tool for enhancing patient–clinician communication.
We develop a conceptual framework describing the potential effects of the use of PROMs in chronic care management. The framework summarizes insights from the methods for evaluating the clinical effectiveness and methods for the health technology assessment of diagnostic technologies and results from the relevant studies.
The framework describes potential effects, from proximal to distal, including communication (patient–clinician, patient–relative, clinician–clinician, and clinician–relative), engaging patients in shared clinical decision making, patient management (clinician management and patient self-management), and patient outcomes. Important potential effects also include enhancement in patient activation as well as improvements in clinician and patient satisfaction, and patient adherence to recommended treatment. Previous frameworks have described patient–physician communication, patient satisfaction, and health outcomes. Our framework adds unique domains, including patient engagement, patient activation, shared clinical decision making, and patient self-management.
The framework can be used as a tool to guide the development of interventions to improve chronic care management through the use of PROMs.
KeywordsPatient-reported measures Chronic care management Patient–clinician communication Patient engagement Patient self-management Share decision making Patient outcomes
The authors would like to thank the valuable contributions from three anonymous reviewers.
- 1.Global status report on noncommunicable diseases (2010). www.who.int/nmh/publications_ncd_report_full_en.pdf (last visited November 18, 2013).
- 4.Parekh, A. K., Goodman, R. A., Gordon, K., Koh, H. K., & the HHS interagency workgroup on multiple chronic conditions. (2011). Managing multiple chronic conditions: A strategic framework for improving health outcomes and quality of life. Public Health Reports, 126, 460–470.PubMedCentralPubMedGoogle Scholar
- 11.Wu, A. (1996) The role of quality assessments in medical practice. Bert Spilker, (Ed.). Philadelphia: Lippincott-Raven.Google Scholar
- 16.Santana, M. J., Feeny, D., Johnson, J. A., McAlister, F. A., Kim, D., Weinkauf, J., et al. (2010). An assessment of the effects of the use of measures of health-related quality of life in routine clinical care: An application to lung transplantation. Quality of Life Research, 19(3), 371–379.PubMedCrossRefGoogle Scholar
- 27.Rosenbloom, S. K., Victorson, D. E., Hanh, E. A., Peterman, A. H., & Cella, D. (2007). Assessment is not enough: A randomized controlled trial of the effects of health-related quality of life assessment on quality of life and satisfaction in oncology clinical practice. Psychooncology, 16, 1069–1079.PubMedCrossRefGoogle Scholar
- 28.Gutteling, J. J., Darlington, A. S., Janssen, H. L., Duivenvoorden, H. J., Busschbach, J. J., & de Man, R. A. (2008). Effectiveness of health-related quality of life measurement in clinical practice: A prospective, randomized controlled trial in patients with chronic liver disease and their physicians. Quality of Life Research, 17, 195–205.PubMedCentralPubMedCrossRefGoogle Scholar
- 29.de Wit, M., Delemarre-van de Waal, H. A., Bokma, J. A., Haasnoot, K., Houdijk, M., Gemke, R. J., et al. (2008). Monitoring and discussing health related quality of life in adolescent with type 1 diabetes improve psychosocial well-being. Diabetes Care, 31(8), 1521–1526.PubMedCentralPubMedCrossRefGoogle Scholar
- 31.Boyce, M.B., Browne, J.P. (2013). Does providing feedback on patient-reported outcomes to healthcare professionals result in better outcomes for patients? A systematic review. Quality of Life Research. [ePub ahead of print].Google Scholar
- 33.Aaronson, N.K., Choucair, A.K., Elliott, T.E., Greenhalgh, J., Halyard, M.Y., Hess, R., Miller, D.M., Reeve, B.B., Santana, M.J., Snyder, C.F. (2011). User’s guide to implementing patient-reported outcomes assessment in clinical practice. http://www.isoqol.org (last access March 2, 2013).
- 34.Roter, D. L., & Hall, J. A. (2006). Doctors talking with patients/patients talking to doctors. Westport, CT: Praeger.Google Scholar
- 35.Roter, D. L. The enduring and evolving nature of the patient-physician relationship. Patient Education Counselling, 39, 5–15.Google Scholar
- 40.Gerrity, P. (2010). And to think that it happened on 11th street: A nursing approach to community-based holistic care and health care reform. Alternative Therapies, 6(5), 62–67.Google Scholar
- 42.Epstein, R. M., & Street, R. L, Jr. (2007). Patient-centered communication in cancer care: Promoting healing and reducing suffering. Bethesda, MD: National Cancer Institute. (NIH Publication No 07-6225).Google Scholar
- 45.McGreevey, M. (2006). Patient as partners: How to involve patient and families in Their Own Care. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations.Google Scholar
- 47.Chow, A., Mayer, E. K., Darzi, A. W., & Athanasiou, T. (2009). Patient-reported outcome measures: The importance of patient satisfaction in surgery. Journal of Surgery, 146(3), 435–443.Google Scholar
- 51.Korda, H. Patient Satisfaction: The new rules of engagement. The Health Care Blog. http://thehealthcareblog.com/blog/2012/10/26/patient-satisfaction-the-new-rules-of-engagement/ (last access August 26, 2013).
- 52.Loring, K. R., Sobel, D. S., Ritter, P. L., Laurent, D., & Hobbs, M. (2001). Effects of the self-management program on patient with chronic disease. Effective Clinical Practice, 4(6), 256–262.Google Scholar
- 54.Marshall, S. S., Haywood, K. L., & Fitzpatrick, R. (2005). Patient involvement and collaboration in shared decision-making: A structure review to inform chronic disease management. Report from the patient-reported health instruments group to the Department of Health.Google Scholar
- 61.Rivkin, M. O., & Bush, P. J. (1974). The satisfaction continuum in health care: Consumer and provider preferences. In S. J. Mushkin (Ed.), Consumer incentives for health care. New York: Prodist.Google Scholar
- 64.Olsen, L. A., Aisner, D., & McGinnis, J. The learning healthcare system: Workshop summary (IOM Roundtable on Evidence-Based Medicine). Roundtable on Evidence-Based Medicine. http://www.ncbi.nlm.nih.gov/books/NBK53494/pdf/TOC.pdf (last access December 3, 2013).