Using an implementation science approach to implement and evaluate patient‑reported outcome measures (PROM) initiatives in routine care settings

<p><strong>Purpose:</strong>&nbsp;Patient-reported outcome and experience measures (PROMs/PREMs) are well established in research for many health conditions, but barriers persist for implementing them in routine care. Implementation science (IS) offers a potential way forward,...

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Hlavní autoři: Stover, A, Haverman, L, van Oers, H, Greenhalgh, J, Potter, C
Médium: Journal article
Jazyk:English
Vydáno: Springer 2020
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author Stover, A
Haverman, L
van Oers, H
Greenhalgh, J
Potter, C
author_facet Stover, A
Haverman, L
van Oers, H
Greenhalgh, J
Potter, C
author_sort Stover, A
collection OXFORD
description <p><strong>Purpose:</strong>&nbsp;Patient-reported outcome and experience measures (PROMs/PREMs) are well established in research for many health conditions, but barriers persist for implementing them in routine care. Implementation science (IS) offers a potential way forward, but its application has been limited for PROMs/PREMs.</p> <p><strong>Methods:</strong>&nbsp;We compare similarities and differences for widely used IS frameworks and their applicability for implementing PROMs/PREMs through case studies. Three case studies implemented PROMs: (1) pain clinics in Canada; (2) oncology clinics in Australia; and (3) pediatric/adult clinics for chronic conditions in the Netherlands. The fourth case study is planning PREMs implementation in Canadian primary care clinics. We compare case studies on barriers, enablers, implementation strategies, and evaluation.</p> <p><strong>Results:</strong>&nbsp;Case studies used IS frameworks to systematize barriers, to develop implementation strategies for clinics, and to evaluate implementation effectiveness. Across case studies, consistent PROM/PREM implementation barriers were technology, uncertainty about how or why to use PROMs/PREMs, and competing demands from established clinical workflows. Enabling factors in clinics were context specific. Implementation support strategies changed during pre-implementation, implementation, and post-implementation stages. Evaluation approaches were inconsistent across case studies, and thus, we present example evaluation metrics specific to PROMs/PREMs.</p> <p><strong>Conclusion:</strong>&nbsp;Multilevel IS frameworks are necessary for PROM/PREM implementation given the complexity. In cross-study comparisons, barriers to PROM/PREM implementation were consistent across patient populations and care settings, but enablers were context specific, suggesting the need for tailored implementation strategies based on clinic resources. Theoretically guided studies are needed to clarify how, why, and in what circumstances IS principles lead to successful PROM/PREM integration and sustainability.</p>
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spelling oxford-uuid:7c3307d0-18f4-4d2c-a097-52f7b9a4b3a42022-03-26T20:55:38ZUsing an implementation science approach to implement and evaluate patient‑reported outcome measures (PROM) initiatives in routine care settingsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7c3307d0-18f4-4d2c-a097-52f7b9a4b3a4EnglishSymplectic ElementsSpringer2020Stover, AHaverman, Lvan Oers, HGreenhalgh, JPotter, C<p><strong>Purpose:</strong>&nbsp;Patient-reported outcome and experience measures (PROMs/PREMs) are well established in research for many health conditions, but barriers persist for implementing them in routine care. Implementation science (IS) offers a potential way forward, but its application has been limited for PROMs/PREMs.</p> <p><strong>Methods:</strong>&nbsp;We compare similarities and differences for widely used IS frameworks and their applicability for implementing PROMs/PREMs through case studies. Three case studies implemented PROMs: (1) pain clinics in Canada; (2) oncology clinics in Australia; and (3) pediatric/adult clinics for chronic conditions in the Netherlands. The fourth case study is planning PREMs implementation in Canadian primary care clinics. We compare case studies on barriers, enablers, implementation strategies, and evaluation.</p> <p><strong>Results:</strong>&nbsp;Case studies used IS frameworks to systematize barriers, to develop implementation strategies for clinics, and to evaluate implementation effectiveness. Across case studies, consistent PROM/PREM implementation barriers were technology, uncertainty about how or why to use PROMs/PREMs, and competing demands from established clinical workflows. Enabling factors in clinics were context specific. Implementation support strategies changed during pre-implementation, implementation, and post-implementation stages. Evaluation approaches were inconsistent across case studies, and thus, we present example evaluation metrics specific to PROMs/PREMs.</p> <p><strong>Conclusion:</strong>&nbsp;Multilevel IS frameworks are necessary for PROM/PREM implementation given the complexity. In cross-study comparisons, barriers to PROM/PREM implementation were consistent across patient populations and care settings, but enablers were context specific, suggesting the need for tailored implementation strategies based on clinic resources. Theoretically guided studies are needed to clarify how, why, and in what circumstances IS principles lead to successful PROM/PREM integration and sustainability.</p>
spellingShingle Stover, A
Haverman, L
van Oers, H
Greenhalgh, J
Potter, C
Using an implementation science approach to implement and evaluate patient‑reported outcome measures (PROM) initiatives in routine care settings
title Using an implementation science approach to implement and evaluate patient‑reported outcome measures (PROM) initiatives in routine care settings
title_full Using an implementation science approach to implement and evaluate patient‑reported outcome measures (PROM) initiatives in routine care settings
title_fullStr Using an implementation science approach to implement and evaluate patient‑reported outcome measures (PROM) initiatives in routine care settings
title_full_unstemmed Using an implementation science approach to implement and evaluate patient‑reported outcome measures (PROM) initiatives in routine care settings
title_short Using an implementation science approach to implement and evaluate patient‑reported outcome measures (PROM) initiatives in routine care settings
title_sort using an implementation science approach to implement and evaluate patient reported outcome measures prom initiatives in routine care settings
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