Noonan Vanessa K, Lyddiatt Anne, Ware Patrick, Jaglal Susan B, Riopelle Richard J, Bingham Clifton O, Figueiredo Sabrina, Sawatzky Richard, Santana Maria, Bartlett Susan J, Ahmed Sara
Blusson Spinal Cord Centre, Rick Hansen Institute, 818 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1M9; Department of Orthopaedics, Faculty of Medicine, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1M9.
CIHR SPOR National Steering Committee.
J Clin Epidemiol. 2017 Sep;89:125-135. doi: 10.1016/j.jclinepi.2017.04.017. Epub 2017 Apr 20.
There is a shift toward making health care patient centered, whereby patients are part of medical decision-making and take responsibility for managing their health. Patient-reported outcomes (PROs) capture the patient voice and can be used to engage patients in medical decision-making.
The objective of this paper is to present important factors from patients', clinicians', researchers', and decision-makers' perspectives that influence successful adoption of PROs in clinical practice. Factors recommended in this paper were informed by a patient partner.
Based on themes arising from the Montreal Accord proceedings, we describe factors that influence the adoption of PROs and how PROs can have a positive effect by enhancing communication and providing opportunities to engage patients, carers, and clinicians in care. Consideration of patient factors (e.g., health literacy), family support and networks (e.g., peer-support networks), technology (e.g., e-health), and health care system factors (e.g., resources to implement PROs) is necessary to ensure PROs are successfully adopted. PRO evaluation plans most likely to succeed over the long term are those incorporating PROs identified by patients as necessary for self-management and that coincide with providers' needs for collaboratively developing treatment plans with patients and families.
医疗保健正朝着以患者为中心转变,即患者成为医疗决策的一部分并负责管理自身健康。患者报告结局(PROs)反映了患者的声音,可用于让患者参与医疗决策。
本文的目的是从患者、临床医生、研究人员和决策者的角度介绍影响PROs在临床实践中成功应用的重要因素。本文推荐的因素由患者合作伙伴提供参考。
基于《蒙特利尔协议》会议产生的主题,我们描述了影响PROs应用的因素,以及PROs如何通过加强沟通并为患者、护理人员和临床医生参与护理提供机会而产生积极影响。为确保PROs成功应用,有必要考虑患者因素(如健康素养)、家庭支持和网络(如同伴支持网络)、技术(如电子健康)以及医疗保健系统因素(如实施PROs的资源)。最有可能长期成功的PRO评估计划是那些纳入患者认为自我管理所必需的PROs,并且与提供者与患者及家庭共同制定治疗计划的需求相一致的计划。