Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability

Abstract Background 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. Methods We sampled...

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Main Authors: Natasha K. Brusco, Victoria Atkinson, Jeffrey Woods, Paul S. Myles, Anita Hodge, Cathy Jones, Damien Lloyd, Vincent Rovtar, Amanda M. Clifford, Meg E. Morris
Format: Article
Language:English
Published: SpringerOpen 2022-07-01
Series:Journal of Patient-Reported Outcomes
Subjects:
Online Access:https://doi.org/10.1186/s41687-022-00483-6
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author Natasha K. Brusco
Victoria Atkinson
Jeffrey Woods
Paul S. Myles
Anita Hodge
Cathy Jones
Damien Lloyd
Vincent Rovtar
Amanda M. Clifford
Meg E. Morris
author_facet Natasha K. Brusco
Victoria Atkinson
Jeffrey Woods
Paul S. Myles
Anita Hodge
Cathy Jones
Damien Lloyd
Vincent Rovtar
Amanda M. Clifford
Meg E. Morris
author_sort Natasha K. Brusco
collection DOAJ
description Abstract Background 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. Methods 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. Results 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. Conclusion 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). Key points 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.
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spelling doaj.art-23c1d8844034449399f8364f2ac5de4c2022-12-22T02:44:08ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202022-07-016111710.1186/s41687-022-00483-6Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptabilityNatasha K. Brusco0Victoria Atkinson1Jeffrey Woods2Paul S. Myles3Anita Hodge4Cathy Jones5Damien Lloyd6Vincent Rovtar7Amanda M. Clifford8Meg E. Morris9Academic and Research Collaborative in Health (ARCH), La Trobe UniversityAcademic and Research Collaborative in Health (ARCH), La Trobe UniversityAcademic and Research Collaborative in Health (ARCH), La Trobe UniversityAnaesthesiology and Perioperative Medicine, Central Clinical School, Alfred Hospital and Monash UniversityAcademic and Research Collaborative in Health (ARCH), La Trobe UniversityAcademic and Research Collaborative in Health (ARCH), La Trobe UniversityAcademic and Research Collaborative in Health (ARCH), La Trobe UniversityHealthscope LimitedSchool of Allied Health, Health Research Institute, Ageing Research Centre, University of LimerickAcademic and Research Collaborative in Health (ARCH), La Trobe UniversityAbstract Background 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. Methods 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. Results 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. Conclusion 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). Key points 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.https://doi.org/10.1186/s41687-022-00483-6Patient reported outcome measure (PROM)ConsumerHospitalFeasibilityAcceptabilityCo-design
spellingShingle Natasha K. Brusco
Victoria Atkinson
Jeffrey Woods
Paul S. Myles
Anita Hodge
Cathy Jones
Damien Lloyd
Vincent Rovtar
Amanda M. Clifford
Meg E. Morris
Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability
Journal of Patient-Reported Outcomes
Patient reported outcome measure (PROM)
Consumer
Hospital
Feasibility
Acceptability
Co-design
title Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability
title_full Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability
title_fullStr Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability
title_full_unstemmed Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability
title_short Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability
title_sort implementing proms for elective surgery patients feasibility response rate degree of recovery and patient acceptability
topic Patient reported outcome measure (PROM)
Consumer
Hospital
Feasibility
Acceptability
Co-design
url https://doi.org/10.1186/s41687-022-00483-6
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