Patient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative study

Abstract Background This article addresses patient-reported outcome (PRO)-based follow-up used as a substitute for regularly scheduled follow-ups. In PRO-based follow-up, patients’ PRO data filled in by the patients at home are used by clinicians as a decision aid to identify those who need clinical...

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Main Authors: Caroline Trillingsgaard Mejdahl, Liv Marit Valen Schougaard, Niels Henrik Hjollund, Erik Riiskjær, Kirsten Lomborg
Format: Article
Language:English
Published: SpringerOpen 2020-01-01
Series:Journal of Patient-Reported Outcomes
Subjects:
Online Access:https://doi.org/10.1186/s41687-019-0170-x
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author Caroline Trillingsgaard Mejdahl
Liv Marit Valen Schougaard
Niels Henrik Hjollund
Erik Riiskjær
Kirsten Lomborg
author_facet Caroline Trillingsgaard Mejdahl
Liv Marit Valen Schougaard
Niels Henrik Hjollund
Erik Riiskjær
Kirsten Lomborg
author_sort Caroline Trillingsgaard Mejdahl
collection DOAJ
description Abstract Background This article addresses patient-reported outcome (PRO)-based follow-up used as a substitute for regularly scheduled follow-ups. In PRO-based follow-up, patients’ PRO data filled in by the patients at home are used by clinicians as a decision aid to identify those who need clinical attention based on an automated PRO algorithm, clinical attention being either a phone call or a physical consultation. A physical consultation in the outpatient clinic prompted by the patient’s PRO is termed a “PRO consultation.” In this multi-perspective qualitative study, we explored the influence of patients’ self-reported data on patient-clinician interaction during PRO consultations in epilepsy outpatient clinics. Interpretive description was the methodological approach, applying data from participant observations, informal interviews with clinicians, and semi-structured interviews with clinicians and patients. Results We found that application and deliberate use of patients’ PRO measures can affect patient-clinician interaction, promoting patient involvement in terms of improved communication and increased patient activation. These findings reflect the general patterns that have been reported in the literature. In addition, we found that PRO measures also may induce unmet expectations among some patients that can have a negative effect on patients’ experiences of the interaction and their follow-up experience in general. We extracted two thematic patterns that represent PRO measures’ potential for patient involvement in the patient-clinician interaction. The first pattern represents enablers, and the second pattern represents barriers for PRO measures to affect patient involvement. Conclusions Applying PRO measures in clinical practice does not automatically enhance the patient-clinician interaction. To strengthen the benefits of PRO measures, the following supplementary clinical initiatives are suggested: summarizing and reporting the PRO measures back to the patient, considering carefully which PRO measures to include, training clinicians and assuring that the patients’ introduction to PRO-based follow-up clarifies expectations.
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spelling doaj.art-5ce6bac2cd8e490e9622ed5e3b2f50492022-12-21T23:01:56ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202020-01-014111010.1186/s41687-019-0170-xPatient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative studyCaroline Trillingsgaard Mejdahl0Liv Marit Valen Schougaard1Niels Henrik Hjollund2Erik Riiskjær3Kirsten Lomborg4AmbuFlex/WestChronic, Occupational Medicine, University Research Clinic, Aarhus University, HerningAmbuFlex/WestChronic, Occupational Medicine, University Research Clinic, Aarhus University, HerningAmbuFlex/WestChronic, Occupational Medicine, University Research Clinic, Aarhus University, HerningDEFACTUM, Social & Health Services and Labour MarketThe Research Centre for Patient Involvement, Aarhus University & the Central Denmark RegionAbstract Background This article addresses patient-reported outcome (PRO)-based follow-up used as a substitute for regularly scheduled follow-ups. In PRO-based follow-up, patients’ PRO data filled in by the patients at home are used by clinicians as a decision aid to identify those who need clinical attention based on an automated PRO algorithm, clinical attention being either a phone call or a physical consultation. A physical consultation in the outpatient clinic prompted by the patient’s PRO is termed a “PRO consultation.” In this multi-perspective qualitative study, we explored the influence of patients’ self-reported data on patient-clinician interaction during PRO consultations in epilepsy outpatient clinics. Interpretive description was the methodological approach, applying data from participant observations, informal interviews with clinicians, and semi-structured interviews with clinicians and patients. Results We found that application and deliberate use of patients’ PRO measures can affect patient-clinician interaction, promoting patient involvement in terms of improved communication and increased patient activation. These findings reflect the general patterns that have been reported in the literature. In addition, we found that PRO measures also may induce unmet expectations among some patients that can have a negative effect on patients’ experiences of the interaction and their follow-up experience in general. We extracted two thematic patterns that represent PRO measures’ potential for patient involvement in the patient-clinician interaction. The first pattern represents enablers, and the second pattern represents barriers for PRO measures to affect patient involvement. Conclusions Applying PRO measures in clinical practice does not automatically enhance the patient-clinician interaction. To strengthen the benefits of PRO measures, the following supplementary clinical initiatives are suggested: summarizing and reporting the PRO measures back to the patient, considering carefully which PRO measures to include, training clinicians and assuring that the patients’ introduction to PRO-based follow-up clarifies expectations.https://doi.org/10.1186/s41687-019-0170-xPatient-reported outcome (PRO) measuresOutpatient follow-upQualitative researchInterpretive descriptionPatient-clinician interactionCommunication
spellingShingle Caroline Trillingsgaard Mejdahl
Liv Marit Valen Schougaard
Niels Henrik Hjollund
Erik Riiskjær
Kirsten Lomborg
Patient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative study
Journal of Patient-Reported Outcomes
Patient-reported outcome (PRO) measures
Outpatient follow-up
Qualitative research
Interpretive description
Patient-clinician interaction
Communication
title Patient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative study
title_full Patient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative study
title_fullStr Patient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative study
title_full_unstemmed Patient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative study
title_short Patient-reported outcome measures in the interaction between patient and clinician – a multi-perspective qualitative study
title_sort patient reported outcome measures in the interaction between patient and clinician a multi perspective qualitative study
topic Patient-reported outcome (PRO) measures
Outpatient follow-up
Qualitative research
Interpretive description
Patient-clinician interaction
Communication
url https://doi.org/10.1186/s41687-019-0170-x
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