Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands.
Health Expect. 2019 Oct;22(5):939-951. doi: 10.1111/hex.12899. Epub 2019 Jun 14.
The use of patient-reported outcomes measures (PROMs), such as quality of life or symptoms like pain or fatigue, is increasingly embraced within patient-centred care and shared decision making.
To investigate: (a) how patients and health professionals think about using PROMs during routine medical consultations; (b) for which purpose(s), patients and health professionals want to use PROMs during those consultations; and (c) how patients interpret PROMs information presented in various formats. People with Parkinson's disease and their health professionals served as case example.
We performed semi-structured interviews with patients (N = 13) and professionals (N = 7 neurologists; N = 7 physiotherapists). We also used a survey in which patients (N = 115) were shown six figures displaying different information types. Presentation formats of this information varied (line/bar graphs). Interpretation by patients, perceived usefulness of information, attitude towards using information during routine medical consultations and (hypothetical) decisions were assessed.
Patients and professionals were generally positive about using PROMs during medical consultations. Professionals stressed the opportunity to monitor changes in individual PROMs over time. Patients were primarily positive about aggregated PROMs to make treatment decisions. This information was also most often interpreted correctly, especially when presented through a line graph (90.1% correct). Professionals thought patients should take the initiative in discussing PROMs, whereas patients thought professionals should do so.
CONCLUSION/DISCUSSION: When used in routine medical consultations, PROMs seem to have potential to support shared decision making and facilitate patient-professional communication. However, training seems needed for both patients and professionals to facilitate actual discussion and proper interpretation.
患者报告结局测量(PROMs)的使用,如生活质量或疼痛或疲劳等症状,在以患者为中心的护理和共同决策中越来越受到重视。
调查:(a)患者和卫生专业人员在常规医疗咨询中如何考虑使用 PROMs;(b)患者和卫生专业人员希望在这些咨询中出于哪些目的使用 PROMs;(c)患者如何解释以各种格式呈现的 PROMs 信息。以帕金森病患者及其卫生专业人员为例。
我们对患者(N=13)和专业人员(N=7 名神经科医生;N=7 名物理治疗师)进行了半结构化访谈。我们还使用了一项调查,其中向 115 名患者展示了六个显示不同信息类型的图表。信息的呈现格式(线/柱状图)有所不同。评估了患者的解释、信息的有用性感知、在常规医疗咨询中使用信息的态度和(假设)决策。
患者和专业人员普遍对在医疗咨询中使用 PROMs 持积极态度。专业人员强调了随着时间的推移监测个体 PROM 变化的机会。患者主要对汇总的 PROMs 用于做出治疗决策持积极态度。特别是当通过线图呈现时,这种信息也经常被正确解释(90.1%正确)。专业人员认为患者应该主动讨论 PROMs,而患者则认为专业人员应该这样做。
结论/讨论:当在常规医疗咨询中使用时,PROMs 似乎有可能支持共同决策并促进患者与专业人员之间的沟通。然而,似乎需要对患者和专业人员进行培训,以促进实际讨论和正确解释。