The use of patient-reported measures (PRMs) has been extensively studied over the last thirty years. Hundreds of PROMs have been developed to incorporate the perspectives of patients in clinical research, quality improvement, and policy development. PRMs offer a standardised and cost-effective method of gathering information on complex outcomes, such as daily functioning. The interest in PROMs has recently grown among clinicians, healthcare providers, and health system-level policy developers.
In this article, we discuss evidence on:
- PRMs in clinical practice (micro level)
- PRMs in quality improvement and research (meso level)
- PRMs in population surveillance and health policy (macro level)
PRMs in clinical practice (micro level)
PRMs are useful in clinical practice as they contribute to providing person-centered care and have the potential to improve communication between clinicians and patients.
In clinical consultations, PRMs are being used to help patients to raise concerns with their clinicians, sensitize patients to health issues, assist in identifying health issues, facilitate tracking of health outcomes, enable comparisons of patient outcomes, and promote shared decision-making between the patient and clinician.
The use of PRMs in daily practice has been shown to improve communication between patients and clinicians, particularly when summaries of PRMs responses are made available to clinicians, leading to more frequent discussions about health-related quality-of-life issues during consultations.
PRMs in quality improvement and research (meso level)
PRMs have been used extensively in research and increasingly in clinical registries and quality improvement activities.
By analysing PRMs responses from many patients, healthcare providers can generate information on the comparative effectiveness of treatments, the effectiveness of quality improvement activities, and variations in care, costs, and outcomes among providers.
This information can be used to inform shared decision-making, identify best practices, inform future quality improvement activities, and compare healthcare providers.
PRMs in clinical research
PRMs have become a common tool in clinical trials of medical interventions. PRMs can provide valuable information to assess the benefits and risks of preventing, diagnosing, treating, and monitoring clinical conditions. The data collected through PRMs can also assist in shared decision-making, empowering patients to make informed decisions about their treatment options.
PRMs in quality improvements
PRMs can be useful for comparing and benchmarking processes and outcomes against industry standards or other healthcare providers. This can identify areas of potential improvement and highlight best practices.
PRMs in population surveillance and health policy (macro level)
PROMs have gained attention in the wider healthcare system, with potential uses including patients using PROMs responses to make informed choices on healthcare providers, healthcare providers using responses to drive improvements in quality, safety, and efficiency, and regulatory bodies and manufacturers understanding the risks and benefits of medical devices, surgical techniques, and pharmaceuticals.
Additionally, PROMs can inform decision-making in establishing and evaluating policies for the benefit of entire populations, including conducting population surveillance of outcome trends, identifying factors associated with value for payment models, and informing system-wide quality improvement activities.