Development of a PROM to measure patient-centredness in chronic care consultations in primary care

Anne Holm; Anna Bernhardt Lyhnebeck; Sussi Friis Buhl; Kristine Bissenbakker; Jette Kolding Kristensen; Anne Møller; Anders Prior; Zaza Kamper-Jørgensen; Sidsel Böcher; Mads Aage Toft Kristensen; Asger Waagepetersen; Anders Hye Dalsgaard; Volkert Siersma; Ann Dorrit Guassora; John Brandt Brodersen; on behalf MM600 trial group; Tora Grauers Willadsen; Susanne Reventlow; Sofie Rosenlund Lau; Sanne Lykke Lundstrøm; Per Kallestrup; Maarten Pieter Rozing; Mette Bech Risør; Marius Brostrøm Kousgaard; Maria Haahr Nielsen; Line Bjørnskov Pedersen; Katrine Tranberg Jensen; John Sahl Andersen; Jesper Bo Nielsen; Jens Søndergård; Janus Laust Thomsen; Iben Charlotte Aaman; Henrik Larsen; Frans Waldorff; Camilla Merrild; Barbara Ann Barret; Ann Kathrin Lindahl Christiansen; Anne Frølich; Anders Stockmar

doi:10.1186/s12955-024-02327-x

Development of a PROM to measure patient-centredness in chronic care consultations in primary care

Anne Holm^*, Anna Bernhardt Lyhnebeck, Sussi Friis Buhl, Kristine Bissenbakker, Jette Kolding Kristensen, Anne Møller, Anders Prior, Zaza Kamper-Jørgensen, Sidsel Böcher, Mads Aage Toft Kristensen, Asger Waagepetersen, Anders Hye Dalsgaard, Volkert Siersma, Ann Dorrit Guassora, John Brandt Brodersen, on behalf MM600 trial group, Tora Grauers Willadsen (Member of author group), Susanne Reventlow (Member of author group), Sofie Rosenlund Lau (Member of author group), Sanne Lykke Lundstrøm (Member of author group)Per Kallestrup (Member of author group), Maarten Pieter Rozing (Member of author group), Mette Bech Risør (Member of author group), Marius Brostrøm Kousgaard (Member of author group), Maria Haahr Nielsen (Member of author group), Line Bjørnskov Pedersen (Member of author group), Katrine Tranberg Jensen (Member of author group), John Sahl Andersen (Member of author group), Jesper Bo Nielsen (Member of author group), Jens Søndergård (Member of author group), Janus Laust Thomsen (Member of author group), Iben Charlotte Aaman (Member of author group), Henrik Larsen (Member of author group), Frans Waldorff (Member of author group), Camilla Merrild (Member of author group), Barbara Ann Barret (Member of author group), Ann Kathrin Lindahl Christiansen (Member of author group), Anne Frølich (Member of author group), Anders Stockmar (Member of author group)

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

Abstract

Introduction

Validated patient-reported outcome measures (PROMs) are crucial for assessing patients’ experiences in the healthcare system. Both clinically and theoretically, patient-centered consultations are essential in patient-care, and are often suggested as the optimal strategy in caring for patients with multimorbidity.

Aim

To either identify or develop and validate a patient-reported outcome measure (PROM) to assess patient-centredness in consultations for patients with multimorbidity in general practice.

Methods

We attempted to identify an existing PROM through a systematic literature review. If a suitable PROM was not identified, we planned to (1) construct a draft PROM based on items from existing PROMs, (2) conduct group and individual interviews among members of the target population to ensure comprehensibility, comprehensiveness and relevance, and (3) perform a psychometric validation in a broad sample of patients from primary care.

Results

We did not identify an eligible PROM in the literature review. The item extraction and face validity meetings resulted in a new PROM consisting of 47 items divided into five domains: biopsychosocial perspective; `patient-as-person’; sharing power and responsibility; therapeutic alliance; and coordinated care. The interviews resulted in a number of changes to the layout and phrasing as well as the deletion of items. The PROM used in the psychometric validation consisted of 28 items. Psychometric validation showed high internal consistency, overall high reliability, and moderate fit indices in the confirmatory factor analysis for all five domains. Few items demonstrated differential item functioning concerning variables such as age, sex, and education.

Conclusions

This study successfully developed and validated a PROM to measure patient-centredness in consultations for patients with multimorbidity. The five domains demonstrated high reliability and validity, making it a valuable tool for measuring patient-centredness of consultations in general practice.

Trial registration

Trial registration number (data for psychometric validation): https://clinicaltrials.gov: NCT05676541 Registration Date: 2022-12-16.

Original language	English
Article number	4
Journal	Health and Quality of Life Outcomes
Volume	23
Number of pages	12
ISSN	1477-7525
DOIs	https://doi.org/10.1186/s12955-024-02327-x
Publication status	Published - 8. Jan 2025

Keywords

Chronic disease
General practice
Multimorbidity
Patient-centredness
Patient-reported outcome measures
Primary care
Reproducibility of Results
Humans
Middle Aged
Patient-Centered Care
Male
Psychometrics
Randomized Controlled Trials as Topic
Chronic Disease/therapy
Adult
Female
Surveys and Questionnaires
Aged
Primary Health Care
Referral and Consultation
Research Design
Patient Reported Outcome Measures

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10.1186/s12955-024-02327-xLicence: CC BY-NC-ND

Open Access VersionFinal published version, 1.9 MBLicence: CC BY-NC-ND

Cite this

Holm, A., Lyhnebeck, A. B., Buhl, S. F., Bissenbakker, K., Kristensen, J. K., Møller, A., Prior, A., Kamper-Jørgensen, Z., Böcher, S., Kristensen, M. A. T., Waagepetersen, A., Dalsgaard, A. H., Siersma, V., Guassora, A. D., Brodersen, J. B., on behalf MM600 trial group, Willadsen, T. G., Reventlow, S., Lau, S. R., ... Stockmar, A. (2025). Development of a PROM to measure patient-centredness in chronic care consultations in primary care. Health and Quality of Life Outcomes, 23, Article 4. https://doi.org/10.1186/s12955-024-02327-x

@article{26e96943d95245858c6c5b0701894dab,

title = "Development of a PROM to measure patient-centredness in chronic care consultations in primary care",

abstract = "IntroductionValidated patient-reported outcome measures (PROMs) are crucial for assessing patients{\textquoteright} experiences in the healthcare system. Both clinically and theoretically, patient-centered consultations are essential in patient-care, and are often suggested as the optimal strategy in caring for patients with multimorbidity. AimTo either identify or develop and validate a patient-reported outcome measure (PROM) to assess patient-centredness in consultations for patients with multimorbidity in general practice. MethodsWe attempted to identify an existing PROM through a systematic literature review. If a suitable PROM was not identified, we planned to (1) construct a draft PROM based on items from existing PROMs, (2) conduct group and individual interviews among members of the target population to ensure comprehensibility, comprehensiveness and relevance, and (3) perform a psychometric validation in a broad sample of patients from primary care. ResultsWe did not identify an eligible PROM in the literature review. The item extraction and face validity meetings resulted in a new PROM consisting of 47 items divided into five domains: biopsychosocial perspective; `patient-as-person{\textquoteright}; sharing power and responsibility; therapeutic alliance; and coordinated care. The interviews resulted in a number of changes to the layout and phrasing as well as the deletion of items. The PROM used in the psychometric validation consisted of 28 items. Psychometric validation showed high internal consistency, overall high reliability, and moderate fit indices in the confirmatory factor analysis for all five domains. Few items demonstrated differential item functioning concerning variables such as age, sex, and education. ConclusionsThis study successfully developed and validated a PROM to measure patient-centredness in consultations for patients with multimorbidity. The five domains demonstrated high reliability and validity, making it a valuable tool for measuring patient-centredness of consultations in general practice. Trial registrationTrial registration number (data for psychometric validation): https://clinicaltrials.gov: NCT05676541 Registration Date: 2022-12-16.",

keywords = "Chronic disease, General practice, Multimorbidity, Patient-centredness, Patient-reported outcome measures, Primary care, Reproducibility of Results, Humans, Middle Aged, Patient-Centered Care, Male, Psychometrics, Randomized Controlled Trials as Topic, Chronic Disease/therapy, Adult, Female, Surveys and Questionnaires, Aged, Primary Health Care, Referral and Consultation, Research Design, Patient Reported Outcome Measures",

author = "Anne Holm and Lyhnebeck, {Anna Bernhardt} and Buhl, {Sussi Friis} and Kristine Bissenbakker and Kristensen, {Jette Kolding} and Anne M{\o}ller and Anders Prior and Zaza Kamper-J{\o}rgensen and Sidsel B{\"o}cher and Kristensen, {Mads Aage Toft} and Asger Waagepetersen and Dalsgaard, {Anders Hye} and Volkert Siersma and Guassora, {Ann Dorrit} and Brodersen, {John Brandt} and {on behalf MM600 trial group} and Willadsen, {Tora Grauers} and Susanne Reventlow and Lau, {Sofie Rosenlund} and Lundstr{\o}m, {Sanne Lykke} and Per Kallestrup and Rozing, {Maarten Pieter} and Ris{\o}r, {Mette Bech} and Kousgaard, {Marius Brostr{\o}m} and Nielsen, {Maria Haahr} and Pedersen, {Line Bj{\o}rnskov} and Jensen, {Katrine Tranberg} and Andersen, {John Sahl} and Nielsen, {Jesper Bo} and Jens S{\o}nderg{\aa}rd and Thomsen, {Janus Laust} and Aaman, {Iben Charlotte} and Henrik Larsen and Frans Waldorff and Camilla Merrild and Barret, {Barbara Ann} and Christiansen, {Ann Kathrin Lindahl} and Anne Fr{\o}lich and Anders Stockmar",

year = "2025",

month = jan,

day = "8",

doi = "10.1186/s12955-024-02327-x",

language = "English",

volume = "23",

journal = "Health and Quality of Life Outcomes",

issn = "1477-7525",

publisher = "BioMed Central",

}

Holm, A, Lyhnebeck, AB, Buhl, SF, Bissenbakker, K, Kristensen, JK, Møller, A, Prior, A, Kamper-Jørgensen, Z, Böcher, S, Kristensen, MAT, Waagepetersen, A, Dalsgaard, AH, Siersma, V, Guassora, AD, Brodersen, JB, on behalf MM600 trial group, Willadsen, TG, Reventlow, S, Lau, SR, Lundstrøm, SL, Kallestrup, P, Rozing, MP, Risør, MB, Kousgaard, MB, Nielsen, MH, Pedersen, LB, Jensen, KT, Andersen, JS, Nielsen, JB , Søndergård, J, Thomsen, JL, Aaman, IC, Larsen, H, Waldorff, F, Merrild, C, Barret, BA, Christiansen, AKL, Frølich, A & Stockmar, A 2025, 'Development of a PROM to measure patient-centredness in chronic care consultations in primary care', Health and Quality of Life Outcomes, vol. 23, 4. https://doi.org/10.1186/s12955-024-02327-x

TY - JOUR

T1 - Development of a PROM to measure patient-centredness in chronic care consultations in primary care

AU - Holm, Anne

AU - Lyhnebeck, Anna Bernhardt

AU - Buhl, Sussi Friis

AU - Bissenbakker, Kristine

AU - Kristensen, Jette Kolding

AU - Møller, Anne

AU - Prior, Anders

AU - Kamper-Jørgensen, Zaza

AU - Böcher, Sidsel

AU - Kristensen, Mads Aage Toft

AU - Waagepetersen, Asger

AU - Dalsgaard, Anders Hye

AU - Siersma, Volkert

AU - Guassora, Ann Dorrit

AU - Brodersen, John Brandt

AU - on behalf MM600 trial group

A2 - Willadsen, Tora Grauers

A2 - Reventlow, Susanne

A2 - Lau, Sofie Rosenlund

A2 - Lundstrøm, Sanne Lykke

A2 - Kallestrup, Per

A2 - Rozing, Maarten Pieter

A2 - Risør, Mette Bech

A2 - Kousgaard, Marius Brostrøm

A2 - Nielsen, Maria Haahr

A2 - Pedersen, Line Bjørnskov

A2 - Jensen, Katrine Tranberg

A2 - Andersen, John Sahl

A2 - Nielsen, Jesper Bo

A2 - Søndergård, Jens

A2 - Thomsen, Janus Laust

A2 - Aaman, Iben Charlotte

A2 - Larsen, Henrik

A2 - Waldorff, Frans

A2 - Merrild, Camilla

A2 - Barret, Barbara Ann

A2 - Christiansen, Ann Kathrin Lindahl

A2 - Frølich, Anne

A2 - Stockmar, Anders

PY - 2025/1/8

Y1 - 2025/1/8

N2 - IntroductionValidated patient-reported outcome measures (PROMs) are crucial for assessing patients’ experiences in the healthcare system. Both clinically and theoretically, patient-centered consultations are essential in patient-care, and are often suggested as the optimal strategy in caring for patients with multimorbidity. AimTo either identify or develop and validate a patient-reported outcome measure (PROM) to assess patient-centredness in consultations for patients with multimorbidity in general practice. MethodsWe attempted to identify an existing PROM through a systematic literature review. If a suitable PROM was not identified, we planned to (1) construct a draft PROM based on items from existing PROMs, (2) conduct group and individual interviews among members of the target population to ensure comprehensibility, comprehensiveness and relevance, and (3) perform a psychometric validation in a broad sample of patients from primary care. ResultsWe did not identify an eligible PROM in the literature review. The item extraction and face validity meetings resulted in a new PROM consisting of 47 items divided into five domains: biopsychosocial perspective; `patient-as-person’; sharing power and responsibility; therapeutic alliance; and coordinated care. The interviews resulted in a number of changes to the layout and phrasing as well as the deletion of items. The PROM used in the psychometric validation consisted of 28 items. Psychometric validation showed high internal consistency, overall high reliability, and moderate fit indices in the confirmatory factor analysis for all five domains. Few items demonstrated differential item functioning concerning variables such as age, sex, and education. ConclusionsThis study successfully developed and validated a PROM to measure patient-centredness in consultations for patients with multimorbidity. The five domains demonstrated high reliability and validity, making it a valuable tool for measuring patient-centredness of consultations in general practice. Trial registrationTrial registration number (data for psychometric validation): https://clinicaltrials.gov: NCT05676541 Registration Date: 2022-12-16.

AB - IntroductionValidated patient-reported outcome measures (PROMs) are crucial for assessing patients’ experiences in the healthcare system. Both clinically and theoretically, patient-centered consultations are essential in patient-care, and are often suggested as the optimal strategy in caring for patients with multimorbidity. AimTo either identify or develop and validate a patient-reported outcome measure (PROM) to assess patient-centredness in consultations for patients with multimorbidity in general practice. MethodsWe attempted to identify an existing PROM through a systematic literature review. If a suitable PROM was not identified, we planned to (1) construct a draft PROM based on items from existing PROMs, (2) conduct group and individual interviews among members of the target population to ensure comprehensibility, comprehensiveness and relevance, and (3) perform a psychometric validation in a broad sample of patients from primary care. ResultsWe did not identify an eligible PROM in the literature review. The item extraction and face validity meetings resulted in a new PROM consisting of 47 items divided into five domains: biopsychosocial perspective; `patient-as-person’; sharing power and responsibility; therapeutic alliance; and coordinated care. The interviews resulted in a number of changes to the layout and phrasing as well as the deletion of items. The PROM used in the psychometric validation consisted of 28 items. Psychometric validation showed high internal consistency, overall high reliability, and moderate fit indices in the confirmatory factor analysis for all five domains. Few items demonstrated differential item functioning concerning variables such as age, sex, and education. ConclusionsThis study successfully developed and validated a PROM to measure patient-centredness in consultations for patients with multimorbidity. The five domains demonstrated high reliability and validity, making it a valuable tool for measuring patient-centredness of consultations in general practice. Trial registrationTrial registration number (data for psychometric validation): https://clinicaltrials.gov: NCT05676541 Registration Date: 2022-12-16.

KW - Chronic disease

KW - General practice

KW - Multimorbidity

KW - Patient-centredness

KW - Patient-reported outcome measures

KW - Primary care

KW - Reproducibility of Results

KW - Humans

KW - Middle Aged

KW - Patient-Centered Care

KW - Male

KW - Psychometrics

KW - Randomized Controlled Trials as Topic

KW - Chronic Disease/therapy

KW - Adult

KW - Female

KW - Surveys and Questionnaires

KW - Aged

KW - Primary Health Care

KW - Referral and Consultation

KW - Research Design

KW - Patient Reported Outcome Measures

U2 - 10.1186/s12955-024-02327-x

DO - 10.1186/s12955-024-02327-x

M3 - Journal article

C2 - 39780227

AN - SCOPUS:85214435639

SN - 1477-7525

VL - 23

JO - Health and Quality of Life Outcomes

JF - Health and Quality of Life Outcomes

M1 - 4

ER -

Development of a PROM to measure patient-centredness in chronic care consultations in primary care

Abstract

Keywords

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