Perspectives of patients and professionals on the use of patient reported outcome measures in primary care: a systematic review of qualitative studies

A71 Perspectives of patients and professionals on the use of patient-reported outcome measures in primary care: a systematic review of qualitative studies

Background: Although the use of patient-reported outcome measures (PROMs) in healthcare settings has increased substantially over recent years, there is potential for them to play a greater role in primary care.

Aim: The underlying aim was to review and summarise studies exploring patients’ and health professionals’ perspectives on the use of PROMs in primary care, to identify positive and negative factors associated with their use, along with barriers and enablers.

Methods: A qualitative systematic review was conducted in Medline, Embase, PsychInfo and CINAHL from inception until 2016; further relevant references were retrieved through snowballing. Eligible studies were conducted in primary care settings, using qualitative methods, exploring patients and/or healthcare professional’s perspectives on the clinical utility of using PROMs in clinical practice.

Results: 19 studies met the inclusion criteria (4 after 2012), 11 of which were conducted in the UK, reporting on the views of professionals (8), patients (5), and both (7). The majority of studies (12) focused on mood disorders. Patients identified benefits associated with PROMs such as increased awareness, alertness, self-management, feeling validated, and being able to discuss problems they would not otherwise mention. Concerns were raised about PROMs replacing face-to-face consultations, restricting discussion, along with worries about stigma and being identified by illness(es). Professionals reported PROMs to be useful for aiding clinical decisions, monitoring and management options, aiding a better understanding of the longitudinal life of patients. Although PROMs were valued for facilitating communication it was also noted that they undermined the human element of consultations, along with professional intuition and judgement. Burden on GP time was also noted.

Conclusions: Patients and professionals highlighted a number of benefits of using PROMs in clinical practice, particularly in terms of supporting decision making, patient awareness and management/self-management options. However, concerns were voiced about PROMs potentially undermining relational continuity of care.