Litchfield Ian, Greenfield Sheila, Turner Grace M, Finnikin Samuel, Calvert Melanie J
Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK.
BJGP Open. 2021 Feb 23;5(1). doi: 10.3399/bjgpopen20X101135. Print 2021 Jan.
The recently announced long-term plan for the NHS is based on a model of person-centred care, which relies on the sustained engagement of patients, shared decision making, and capability for self-management. For a primary care service under increasing pressure from an ageing and chronically ill population, Patient Reported Outcome Measures (PROMs) appear capable of supporting many of the requirements for person-centred care, yet little is known of the circumstances of their current implementation or how their use might be optimised.
To begin the conversation about how successfully PROMs have been integrated into primary care and how their use might be supported.
DESIGN & SETTING: A qualitative investigation of the perspectives of GPs exploring the use of PROMs as part of routine clinical care in England.
Semi-structured telephone interviews were conducted with GPs from across England. The data were analysed using the Consolidated Framework for Implementation Research (CFIR).
A total of 25 interviews were conducted and GPs described the potential benefit of PROMs in a range of circumstances, but also voiced concerns about their reliability and their potential to constrain consultations. Their flexibility meant they had the potential to be incorporated into existing care processes but only with the requisite logistical support.
Areas that need to be addressed include the creation of a compelling body of evidence of the benefit of PROMs, appropriate training for staff and patients, and a coherent implementation strategy from policymakers and funding bodies.
英国国家医疗服务体系（NHS）最近公布的长期计划基于以患者为中心的护理模式，该模式依赖于患者的持续参与、共同决策以及自我管理能力。对于面临老龄化和慢性病患者群体压力不断增加的基层医疗服务而言，患者报告结局指标（PROMs）似乎能够支持以患者为中心的护理的许多要求，但对于其当前实施情况以及如何优化使用知之甚少。
开始探讨PROMs在基层医疗中整合的成功程度以及如何支持其使用。
对全科医生（GPs）的观点进行定性调查，以探索PROMs在英格兰作为常规临床护理一部分的使用情况。
对来自英格兰各地的全科医生进行半结构化电话访谈。使用实施研究综合框架（CFIR）对数据进行分析。
共进行了25次访谈，全科医生描述了PROMs在一系列情况下的潜在益处，但也表达了对其可靠性以及可能限制会诊的担忧。其灵活性意味着它们有可能被纳入现有的护理流程，但前提是要有必要的后勤支持。
需要解决的领域包括创建关于PROMs益处的有说服力的证据体系、为工作人员和患者提供适当培训，以及政策制定者和资助机构制定连贯的实施策略。
