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在整合医学咨询就诊期间常规收集患者报告结局的理由。

Rationale for routine collection of patient reported outcomes during integrative medicine consultation visits.

机构信息

Integrative Health Research Center, Allina Health, Minneapolis, MN, United States.

Division of Applied Research, Allina Health, Minneapolis, MN, United States.

出版信息

Complement Ther Med. 2018 Apr;37:43-49. doi: 10.1016/j.ctim.2018.01.012. Epub 2018 Jan 31.

DOI:10.1016/j.ctim.2018.01.012
PMID:29609936
Abstract

OBJECTIVES

Integrative medicine (IM) is whole-person care utilizing complementary health approaches to address numerous physical or emotional influences that can impact an individual's health. Patient-reported outcomes (PRO) are subjective measures that quantify patients' perception of their quality of life. While PRO measures have been routinely assessed in specific oncology clinics, our objective was to assess the ability and utility of routine collection of PRO measures in an IM clinic.

DESIGN/SETTING/MAIN OUTCOME: Patients receiving a clinical consultation in an ambulatory IM clinic completed the PROMIS Global Health Form in the clinic waiting room.

RESULTS

From November 2013 through October 2016, the PROMIS Global Health Form (PROMIS-10) was administered during 59% of IM provider consultation visits (7172/12,207), representing 3473 unique patients. Most patients were female (81%), White (93%), middle-aged (49.2; SD 15.4) and had commercial health insurance (66%). Baseline Mental (44.9; SD 9.1) and Physical Health (44.2; SD 8.6) scores were roughly 0.5 standard deviation below the national mean values (50; SD 10). Factors such as age, race and non-commercial insurance were associated with lower PROMIS-10 scores. Patients completing at least two PROMIS-10 questionnaires (n = 1541) exhibited increases of 2.3% and 2.8% from first to last PROMIS-10 assessment in Mental and Physical Heath scores respectively.

CONCLUSIONS

It is possible to routinely collect PRO measures in large IM clinic and longitudinal improvements in Mental and Physical Health scores were observed. Future research should focus on understanding how providers can utilize PRO results in real-time to improve patients' clinical outcomes and potentially decrease healthcare utilization.

摘要

目的

整合医学(IM)是一种整体治疗方法,利用补充健康方法来解决许多可能影响个人健康的身体或情绪影响。患者报告的结果(PRO)是量化患者对其生活质量感知的主观测量。虽然 PRO 测量在特定的肿瘤学诊所中已常规评估,但我们的目标是评估在 IM 诊所中常规收集 PRO 测量的能力和实用性。

设计/设置/主要结果:在门诊 IM 诊所接受临床咨询的患者在诊所等候室完成 PROMIS 全球健康表格。

从 2013 年 11 月至 2016 年 10 月,在 59%的 IM 提供者咨询就诊期间(7172/12207)进行了 PROMIS 全球健康表格(PROMIS-10),代表 3473 名独特患者。大多数患者为女性(81%)、白人(93%)、中年(49.2;SD 15.4),并拥有商业健康保险(66%)。基线心理健康(44.9;SD 9.1)和身体健康(44.2;SD 8.6)评分比全国平均值(50;SD 10)低约 0.5 个标准差。年龄、种族和非商业保险等因素与较低的 PROMIS-10 评分相关。至少完成两次 PROMIS-10 问卷的患者(n=1541)在心理健康和身体健康评分方面,从第一次到最后一次 PROMIS-10 评估分别增加了 2.3%和 2.8%。

结论

在大型 IM 诊所中常规收集 PRO 测量是可行的,并且观察到心理健康和身体健康评分的纵向改善。未来的研究应侧重于了解提供者如何实时利用 PRO 结果来改善患者的临床结果,并可能减少医疗保健利用。

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