Brusco Natasha K, Atkinson Victoria, Woods Jeffrey, Myles Paul S, Hodge Anita, Jones Cathy, Lloyd Damien, Rovtar Vincent, Clifford Amanda M, Morris Meg E
Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, VIC, Australia.
Alpha Crucis Group, Melbourne, VIC, Australia.
J Patient Rep Outcomes. 2022 Jul 7;6(1):73. doi: 10.1186/s41687-022-00483-6.
Patient reported outcome measures (PROMs) engage patients in co-evaluation of their health and wellbeing outcomes. This study aimed to determine the feasibility, response rate, degree of recovery and patient acceptability of a PROM survey for elective surgery.
We sampled patients with a broad range of elective surgeries from four major Australian hospitals to evaluate (1) feasibility of the technology used to implement the PROMs across geographically dispersed sites, (2) response rates for automated short message service (SMS) versus email survey delivery formats, (3) the degree of recovery at one and four weeks post-surgery as measured by the Quality of Recovery 15 Item PROM (QoR-15), and (4) patient acceptability of PROMS based on survey and focus group results. Feasibility and acceptability recommendations were then co-designed with stakeholders, based on the data.
Over three months there were 5985 surveys responses from 20,052 surveys (30% response rate). Feasibility testing revealed minor and infrequent technical difficulties in automated email and SMS administration of PROMs prior to surgery. The response rate for the QoR-15 was 34.8% (n = 3108/8919) for SMS and 25.8% (n = 2877/11,133) for email. Mean QoR-15 scores were 122.1 (SD 25.2; n = 1021); 113.1 (SD 27.7; n = 1906) and 123.4 (SD 26.84; n = 1051) for pre-surgery and one and four weeks post-surgery, respectively. One week after surgery, 825 of the 1906 responses (43%) exceeded 122.6 (pre-surgery average), and at four weeks post-surgery, 676 of the 1051 responses (64%) exceeded 122.6 (pre-surgery average). The PROM survey was highly acceptable with 76% (n = 2830/3739) of patients rating 8/10 or above for acceptability. Fourteen patient driven recommendations were then co-developed.
Administering PROMS electronically for elective surgery hospital patients was feasible, acceptable and discriminated changes in surgical recovery over time. Patient co-design and involvement provided innovative and practical solutions to implementation and new recommendations for implementation. Trial Registration and Ethical Approval ACTRN12621000298819 (Phase I and II) and ACTRN12621000969864 (Phase III). Ethics approval has been obtained from La Trobe University (Australia) Human Research Ethics Committee (HEC20479).
Patient reported outcome measures (PROMs) help to engage patients in understanding their health and wellbeing outcomes. This study aimed to determine how patients feel about completing a PROM survey before and after elective surgery, and to develop a set of recommendations on how to roll out the survey, based on patient feedback. We found that implementing an electronic PROM survey before and after elective surgery was relatively easy to do and was well accepted by patients. Consumer feedback throughout the project enabled co-design of innovative and practical solutions to PROM survey administration.
患者报告结局测量（PROMs）促使患者共同评估其健康和幸福状况。本研究旨在确定一项针对择期手术的PROM调查的可行性、回复率、恢复程度及患者可接受性。
我们从澳大利亚四家主要医院抽取了接受各种择期手术的患者，以评估：（1）在地理上分散的地点实施PROMs所使用技术的可行性；（2）自动短信服务（SMS）与电子邮件调查发送格式的回复率；（3）通过恢复质量15项PROM（QoR - 15）测量的术后1周和4周时的恢复程度；（4）基于调查和焦点小组结果的患者对PROMs的可接受性。然后根据数据与利益相关者共同设计可行性和可接受性建议。
在三个月内，20052份调查中有5985份回复（回复率30%）。可行性测试显示，在术前对PROMs进行自动电子邮件和短信管理时存在轻微且不常见的技术困难。QoR - 15的回复率，短信方式为34.8%（n = 3108/8919），电子邮件方式为25.8%（n = 2877/11133）。术前、术后1周和4周的QoR - 15平均得分分别为122.1（标准差25.2；n = 1021）、113.1（标准差27.7；n = 1906）和123.4（标准差26.84；n = 1051）。术后1周，1906份回复中有825份（43%）超过122.6（术前平均值）；术后4周，1051份回复中有676份（64%）超过122.6（术前平均值）。PROM调查的接受度很高，76%（n = 2830/3739）的患者对可接受性的评分在8/10或以上。随后共同制定了14条由患者推动的建议。
对择期手术住院患者以电子方式管理PROMs是可行的、可接受的，并且能够区分手术恢复过程中随时间的变化。患者共同设计和参与为实施提供了创新且实用的解决方案以及新的实施建议。试验注册和伦理批准：ACTRN12621000298819（I期和II期）以及ACTRN12621000969864（III期）。已获得拉筹伯大学（澳大利亚）人类研究伦理委员会（HEC20479）的伦理批准。
患者报告结局测量（PROMs）有助于促使患者了解其健康和幸福状况。本研究旨在确定患者对在择期手术前后完成PROM调查的感受，并根据患者反馈制定一套关于如何开展该调查的建议。我们发现，在择期手术前后实施电子PROM调查相对容易且患者接受度良好。整个项目中消费者的反馈使得能够共同设计出创新且实用的PROM调查管理解决方案。
