Danish Center for Healthcare Improvements, Department of Business and Management, Aalborg University, Aalborg, Denmark.
Center for General Practice, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
BMC Musculoskelet Disord. 2019 May 17;20(1):230. doi: 10.1186/s12891-019-2620-2.
In the past few decades, there has been an increasing focus on the importance of patient involvement in the health care system. Patient participation executed through patient-reported outcomes (PROs) and the integration of such into clinical practice has been framed as positive for patients, care providers, and the health care system as a whole. This review aims to elucidate and discuss the current and future use of PROs in clinical practice and to identify the most common types of PRO measures (PROMs) used for patients with hip or knee osteoarthritis in different treatment settings.
The following databases were searched: PubMed, Embase, CINAHL, Scopus, the Cochrane Library, and EconLit. For inclusion in the study, studies had to cover either knee or hip osteoarthritis and report on PROs. The type of PROM, treatment setting, and study design of each included study were extracted from their respective abstracts. Additionally, the full text of studies concerning PROs as an integrated part of clinical practice was examined and information on the year of publication, study design, topic, and use of PROMs was extracted.
It was found that only two pilot studies reported on the use of PROs as an integrated part of patient treatment within hip or knee osteoarthritis. In 349 studies, a total of 38 different PROMs relevant for patients with either hip or knee osteoarthritis were identified. The EQ-5D, WOMAC, and VAS questionnaires were the most commonly reported generic, disease-specific, and domain-specific PROMs, respectively. However, a large variation in the use of different PROMs both within and between surgical and nonsurgical settings was found.
Limited evidence on the use of PROs as an integrated part of clinical practice for patients with hip and knee osteoarthritis was found. Further research is necessary to clarify the effects on patient outcomes of using PROs in clinical practice. In addition, there is limited agreement on a joint standard for the use of PROMs both within and across the sectorial boarders. Further exploration of PROMs to generate future standardisation is suggested.
在过去的几十年中，人们越来越关注患者在医疗保健系统中的参与度。通过患者报告的结果（PROs）来实现患者参与，并将其纳入临床实践，被认为对患者、护理提供者和整个医疗保健系统都有积极影响。本综述旨在阐明和讨论 PRO 在临床实践中的当前和未来用途，并确定在不同治疗环境中用于髋或膝关节骨关节炎患者的最常见 PRO 测量类型（PROMs）。
搜索了以下数据库：PubMed、Embase、CINAHL、Scopus、Cochrane 图书馆和 EconLit。纳入研究的标准是必须涵盖膝关节或髋关节骨关节炎，并报告 PRO。从各自的摘要中提取了每个纳入研究的 PROM 类型、治疗环境和研究设计。此外，还检查了作为临床实践综合部分的 PRO 相关研究的全文，并提取了关于出版年份、研究设计、主题和 PROM 使用的信息。
仅发现两项关于将 PRO 作为髋或膝关节骨关节炎患者治疗综合部分的使用的试点研究。在 349 项研究中，总共确定了 38 种与髋或膝关节骨关节炎患者相关的不同 PROM。EQ-5D、WOMAC 和 VAS 问卷分别是最常报告的通用、疾病特异性和特定领域 PROM。然而，在手术和非手术环境中，不同 PROM 的使用存在很大差异。
发现关于将 PRO 作为髋和膝关节骨关节炎患者临床实践综合部分使用的证据有限。需要进一步研究以阐明在临床实践中使用 PRO 对患者结果的影响。此外，在使用 PROM 方面，无论是在内部还是跨越部门边界，都缺乏统一标准的共识。建议进一步探索 PROM 以产生未来的标准化。
