Quality of Life Research

, Volume 27, Issue 12, pp 3157–3166 | Cite as

A qualitative study of patients’ perceptions of the utility of patient-reported outcome measures of symptoms in primary care clinics

  • Tasneem L. TalibEmail author
  • Paige DeChant
  • Jacob Kean
  • Patrick O. Monahan
  • David A. Haggstrom
  • Madison E. Stout
  • Kurt Kroenke



Sleep, pain, anxiety, depression, and low energy/fatigue (SPADE pentad) symptoms are common, but often unrecognized and undertreated in primary care. In an effort to improve symptom outcomes, primary care clinics are integrating patient-reported outcome measures (PROs), such as the Patient-Reported Outcome Measurement Information System (PROMIS), into practice. Whether patients with SPADE symptoms perceive these measures as useful is unknown. The purpose of this qualitative study was to explore patients’ perceptions of the utility of symptom-based PROs in primary care.


As part of a mixed-methods study, 23 patients (age 24–77 years) with one or more SPADE symptoms participated in one-on-one interviews about the use, implementation and visual display of PROMIS. All interviews were audio-recorded, transcribed, and analyzed using thematic analysis.


Five themes emerged: (1) PROs may foster communication about symptoms; (2) data from PROs may prompt clinical actions; (3) the visual display of symptom scores could be useful for patients and providers, though modifications may enhance interpretation; (4) implementation may vary according to patients’ perception of PRO features (e.g., length); and (5) PROs may be useful, but only to the extent that they are valued, prioritized, and used.


According to patients, the use of PROs to measure symptoms in primary care clinics has the potential to be useful. However, patients are reluctant to complete PROs if they perceive that clinicians do not use the measures to improve care. Barriers to implementation in primary care (e.g., duration of visit) should be addressed to enhance the utility of PROs. Clinical trial registration ID: NCT02383862.


Patient-reported outcome measures Symptoms Primary care Qualitative 



Patient-Centered Outcomes Research Institute Contract ME-1403-12043.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Tasneem L. Talib
    • 1
    Email author
  • Paige DeChant
    • 1
  • Jacob Kean
    • 2
  • Patrick O. Monahan
    • 3
  • David A. Haggstrom
    • 1
    • 4
    • 5
  • Madison E. Stout
    • 1
  • Kurt Kroenke
    • 1
    • 4
    • 5
  1. 1.Regenstrief InstituteIndianapolisUSA
  2. 2.University of Utah School of MedicineSalt Lake CityUSA
  3. 3.Department of BiostatisticsIndiana University School of MedicineIndianapolisUSA
  4. 4.Veterans Affairs Health Services Research and Development Center for Health Information and CommunicationIndianapolisUSA
  5. 5.Division of General Internal Medicine and GeriatricsIndiana University School of MedicineIndianapolisUSA

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