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制定社区和初级保健肌肉骨骼服务的核心结局集:共识方法。

Developing a core outcome set for community and primary care musculoskeletal services: A consensus approach.

机构信息

Keele University School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Staffordshire, ST5 5BG, UK; Sandwell and West Birmingham Hospitals NHS Trust, UK.

Keele University School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Staffordshire, ST5 5BG, UK.

出版信息

Musculoskelet Sci Pract. 2021 Oct;55:102415. doi: 10.1016/j.msksp.2021.102415. Epub 2021 Jun 15.

Abstract

BACKGROUND

At present there is no core outcome set (COS) for use in community and primary care Musculoskeletal (MSK) services across the UK. Services are therefore collecting different MSK outcomes and metrics in different ways and at different times. Standardising MSK data collection is essential in order for fair and impactful benchmarking to improve the quality of care delivered to the millions of patients presenting each year with MSK disorders.

OBJECTIVE

To gain consensus on a proposed set of metrics that could be used to develop a COS for use in routine practice in community and primary care MSK services in the UK and to make recommendations to inform a future national MSK audit.

METHODS

A consensus process involving researchers, healthcare professionals and patients. Previous research generated an initial list of proposed metrics. This proposal was then taken to wider stakeholder consensus via an online survey designed for both healthcare professionals and MSK service users.

RESULTS

199 respondents completed the survey, 166 healthcare professionals and 33 service users (25/33 eligible to answer all items within the survey). Metrics that reached strong consensus were; age, pain site, comorbidities, duration of symptoms, work status, work absence, work absence duration. No Patient Reported Outcome Measures (PROMs) met strong consensus and all Patient Reported Experience Measures (PREMs) other than timeliness/convenience met strong consensus criteria.

CONCLUSION

7 baseline factors and 9 PREM domains reached strong consensus. The MSK-HQ PROM was the highest rated outcome measure so was also recommended for inclusion in an MSK COS.

摘要

背景

目前,英国社区和初级保健肌肉骨骼 (MSK) 服务没有核心结局集 (COS)。因此,服务以不同的方式和时间收集不同的 MSK 结局和指标。为了进行公平和有影响力的基准测试,以提高每年为数百万患有 MSK 疾病的患者提供的护理质量,标准化 MSK 数据收集至关重要。

目的

就可用于英国社区和初级保健 MSK 服务常规实践的 COS 中使用的一组拟议指标达成共识,并提出建议,为未来的国家 MSK 审计提供信息。

方法

涉及研究人员、医疗保健专业人员和患者的共识过程。先前的研究产生了一套初步的拟议指标清单。然后,通过专门为医疗保健专业人员和 MSK 服务用户设计的在线调查,将这一提议扩大到更广泛的利益相关者共识中。

结果

199 名受访者完成了调查,其中 166 名医疗保健专业人员和 33 名服务用户(33 名中的 25 名有资格回答调查中的所有项目)。达成强烈共识的指标包括:年龄、疼痛部位、合并症、症状持续时间、工作状态、工作缺勤、工作缺勤持续时间。没有患者报告的结果测量指标 (PROM) 达成强烈共识,所有患者报告的体验测量指标 (PREM) 除及时性/便利性外,均符合强烈共识标准。

结论

7 个基线因素和 9 个 PREM 领域达成强烈共识。MSK-HQ PROM 是评分最高的结局测量指标,因此也被推荐纳入 MSK COS。

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