Soprovich Allison L, Short Hilary, Ali Al-Bakir, Brower Krista, Ohinmaa Arto, Johnson Jeffrey A
Alberta PROMs and EQ-5D Research and Support Unit (APERSU), School of Public Health University of Alberta Edmonton Alberta Canada.
Edmonton O-day'min Primary Care Network Edmonton Alberta Canada.
Health Sci Rep. 2024 Dec 30;8(1):e70308. doi: 10.1002/hsr2.70308. eCollection 2025 Jan.
Patient-reported outcome measures (PROMs) are increasingly used in primary care practices; however, the broad characteristics of this population pose unique challenges. Generic PROMs (e.g., EQ-5D-5L) measure general health status from the patient's perspective, contributing towards a comprehensive evaluation of health programming. This study describes the integration of the EQ-5D-5L within program evaluation in primary care in Alberta, Canada, using two program examples.
A retrospective, longitudinal, observational design was used. The Edmonton O-day'min Primary Care Network (EOPCN) routinely collects the EQ-5D-5L in their exercise and active living and nutrition programs. Data collected between January 1, 2021 and March 31, 2022 was analyzed descriptively, by dimension, index, and visual analog scale (VAS) scores. Minimally important differences were used to interpret index (0.04) and VAS scores (7.0) and the Pareto Classification of Health Change was applied to the dimensions. Effect size of change in index and VAS scores and population comparisons were examined.
In the exercise and active living program ( = 301), 72% were female with a mean age of 57 (±16) years, and 90.2% reported any problems (levels 2-5) in pain/discomfort. The mean index and VAS scores were 0.74 (±0.18) and 66.5 (±18.9), respectively. Among those with repeated measurement (n = 112), the greatest improvement was in usual activities (17%); the greatest deterioration was in pain/discomfort (25%). In the nutrition program ( = 573), 71% were female with a mean age of 50 (±17) years, and 75.9% reported any problems in pain/discomfort. The mean index and VAS scores were 0.77 (±0.19) and 70.1 (±15.6), respectively. Among those with repeated measurement ( = 212), the greatest improvement was in anxiety/depression (16%); the greatest deterioration was in pain/discomfort (26%). In both, health status was lower than the general Alberta population norms. No baseline characteristics were found to be statistically significant.
These results inform future programming, to help patient needs.
患者报告结局测量指标（PROMs）在初级医疗实践中越来越常用；然而，该人群的广泛特征带来了独特的挑战。通用的PROMs（如EQ-5D-5L）从患者角度衡量总体健康状况，有助于对健康规划进行全面评估。本研究使用两个项目实例描述了EQ-5D-5L在加拿大艾伯塔省初级医疗项目评估中的整合情况。
采用回顾性、纵向观察性设计。埃德蒙顿O日初级医疗网络（EOPCN）在其运动与积极生活以及营养项目中常规收集EQ-5D-5L数据。对2021年1月1日至2022年3月31日期间收集的数据按维度、指数和视觉模拟量表（VAS）得分进行描述性分析。使用最小重要差异来解释指数（0.04）和VAS得分（7.0），并将健康变化的帕累托分类应用于各维度。检验指数和VAS得分变化的效应大小以及人群比较情况。
在运动与积极生活项目（n = 301）中，72%为女性，平均年龄57（±16）岁，90.2%报告在疼痛/不适方面存在任何问题（2 - 5级）。平均指数和VAS得分分别为0.74（±0.18）和66.5（±18.9）。在进行重复测量的人群（n = 112）中，改善最大的是日常活动（17%）；恶化最大的是疼痛/不适（25%）。在营养项目（n = 573）中，71%为女性，平均年龄50（±17）岁，75.9%报告在疼痛/不适方面存在任何问题。平均指数和VAS得分分别为0.77（±0.19）和70.1（±15.6）。在进行重复测量的人群（n = 212）中，改善最大的是焦虑/抑郁（16%）；恶化最大的是疼痛/不适（26%）。在这两个项目中，健康状况均低于艾伯塔省总体人群的标准。未发现基线特征具有统计学意义。
这些结果为未来的项目规划提供了参考，以满足患者需求。
