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开发一套荷兰医疗专家护理的标准 PRO 和通用 PROM 集:基于结果的医疗保健计划工作组通用 PROM 的建议。

Development of a standard set of PROs and generic PROMs for Dutch medical specialist care : Recommendations from the Outcome-Based Healthcare Program Working Group Generic PROMs.

机构信息

National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands.

Department of Medical Cell BioPhysics & TechMed Center, University of Twente, Enschede, The Netherlands.

出版信息

Qual Life Res. 2023 Jun;32(6):1595-1605. doi: 10.1007/s11136-022-03328-3. Epub 2023 Feb 9.

Abstract

PURPOSE

The added value of measuring patient-reported outcomes (PROs) for delivering patient-centered care and assessment of healthcare quality is increasingly evident. However, healthcare system wide data collection initiatives are hampered by the proliferation of patient-reported outcome measures (PROMs) and conflicting data collection standards. As part of a national initiative of the Dutch Ministry of Health, Welfare and Sport we developed a consensus-based standard set of generic PROs and PROMs to be implemented across Dutch medical specialist care.

METHODS

A working group of mandated representatives of umbrella organizations involved in Dutch medical specialist care, together with PROM experts and patient organizations worked through a structured, consensus-driven co-creation process. This included literature reviews, online expert and working group meetings, and feedback from national patient- and umbrella organizations. The 'PROM-cycle' methodology was used to select feasible, valid, and reliable PROMs to obtain domain scores for each of the PROs included in the set.

RESULTS

Eight PROs across different domains of health were ultimately endorsed: symptoms (pain & fatigue), functioning (physical, social/participation, mental [anxiety & depression]), and overarching (quality of life & perceived overall health). A limited number of generic PROMs was endorsed. PROMIS short forms were selected as the preferred instruments for all PROs. Several recommendations were formulated to facilitate healthcare system level adoption and implementation of the standard set.

CONCLUSIONS

We developed a consensus-based standard set of Generic PROMs and a set of recommendations to facilitate healthcare system wide implementation across Dutch medical specialist care.

摘要

目的

测量患者报告的结果(PROs)对于提供以患者为中心的护理和评估医疗保健质量的附加值越来越明显。然而,由于患者报告结果测量(PROMs)的大量增加和数据收集标准的冲突,医疗保健系统范围的数据收集倡议受到阻碍。作为荷兰卫生部、福利和体育部国家倡议的一部分,我们制定了一套基于共识的通用 PROs 和 PROMs 标准集,将在荷兰的医学专家护理中实施。

方法

一个由参与荷兰医学专家护理的伞式组织的授权代表、PROM 专家和患者组织组成的工作组,通过一个结构化的、基于共识的共同创造过程进行工作。这包括文献综述、在线专家和工作组会议,以及来自国家患者和伞式组织的反馈。使用“PROM 周期”方法选择可行、有效和可靠的 PROM,以获得纳入该集合的每个 PRO 的领域分数。

结果

最终认可了八个跨越不同健康领域的 PRO:症状(疼痛和疲劳)、功能(身体、社会/参与、心理[焦虑和抑郁])和整体(生活质量和整体健康感知)。认可了为数不多的通用 PROM。PROMIS 短表被选为所有 PRO 的首选工具。为促进医疗保健系统层面的采用和实施标准集制定了若干建议。

结论

我们制定了一套基于共识的通用 PROM 标准集和一套建议,以促进荷兰医学专家护理中广泛实施医疗保健系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2454/10172289/e381ef9821c5/11136_2022_3328_Fig1_HTML.jpg

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