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使用电子患者报告结局指标(ePAQ-MPH)评估妇科长期候诊患者的潜在危害。

Using an electronic patient reported outcome measure (ePAQ-MPH) to assess potential harm for long-waiting patients in gynaecology.

作者信息

Gray Thomas, Johnson Sandra, Prosser-Snelling Edward, Simpson Paul

机构信息

Department of Gynaecology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.

Norwich Medical School, University of East Anglia, Norwich, UK.

出版信息

BMC Womens Health. 2024 Dec 21;24(1):646. doi: 10.1186/s12905-024-03506-0.

Abstract

BACKGROUND

During the COVID-19 pandemic, outpatient waits for gynaecology appointments increased by 60% in the UK National Health Service (NHS). The aim of this study was to use the electronic Personal Assessment Questionnaire-Menstrual, Pain and Hormonal (ePAQ-MPH) electronic patient reported outcome measure (ePROM) to assess symptoms, impact and potential harm for patients waiting > 60 weeks for general gynaecology appointments at a teaching hospital.

METHODS

1070 patients waiting > 60 weeks for a new appointment (range 60-72 weeks) were invited to complete ePAQ-MPH online to measure gynaecological symptoms and health-related quality-of-life (HRQoL). Patients could also call to cancel appointments no longer needed. Non-responders were telephoned weekly for three further weeks and asked to complete ePAQ-MPH. Patients scoring > 80/100 for ePAQ-MPH domains relating to HRQoL had their appointment escalated to be seen within six-eight weeks. Thematic content analysis was undertaken of free-text concerns recorded using ePAQ-MPH.

RESULTS

526 patients completed ePAQ-MPH (49.2%), 169 of these scored greater than 80/100 for one or more HRQoL domains and were seen within 6-8 weeks. 103 patients (9.6%) requested to cancel their appointment. Reasons included problem resolving spontaneously (33%), problem treated by general practitioner (10%) and being seen by a private provider (28%). Commonly recorded free-text concerns related to wanting a diagnosis (n = 142), management of condition (n = 98) and pain management (n = 77).

CONCLUSIONS

ePAQ-MPH may be used effectively to prioritise patients waiting for an outpatient appointment in gynaecology. Wider use of ePROMs to support waiting list validation within the NHS and elsewhere should be considered.

摘要

背景

在新冠疫情期间,英国国家医疗服务体系(NHS)中妇科门诊预约的等待时间增加了60%。本研究的目的是使用电子个人评估问卷-月经、疼痛和激素(ePAQ-MPH)这一电子患者报告结局指标(ePROM),来评估在一家教学医院等待普通妇科门诊预约超过60周的患者的症状、影响及潜在危害。

方法

邀请1070名等待新预约超过60周(范围为60 - 72周)的患者在线完成ePAQ-MPH,以测量妇科症状和健康相关生活质量(HRQoL)。患者也可以致电取消不再需要的预约。对于无回应者,在接下来的三周内每周进行电话随访,并要求他们完成ePAQ-MPH。在与HRQoL相关的ePAQ-MPH领域得分超过80/100的患者,其预约被提前至6 - 8周内就诊。对使用ePAQ-MPH记录的自由文本关注点进行了主题内容分析。

结果

526名患者完成了ePAQ-MPH(49.2%),其中169名患者在一个或多个HRQoL领域得分超过80/100,并在6 - 8周内就诊。103名患者(9.6%)要求取消预约。原因包括问题自行解决(33%)、由全科医生治疗(10%)以及由私立医疗机构诊治(28%)。常见的自由文本关注点包括想要确诊(n = 142)、病情管理(n = 98)和疼痛管理(n = 77)。

结论

ePAQ-MPH可有效用于对等待妇科门诊预约的患者进行优先排序。应考虑在NHS及其他地方更广泛地使用ePROM来支持候诊名单的确认。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bdc/11662428/d69c70c4b627/12905_2024_3506_Fig1_HTML.jpg

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