Niels Henrik Ingvar Hjøllund

Use of patient-reported outcomes in outpatient settings as a means of patient involvement and self-management support: a qualitative study of the patient perspective

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Rationale, aims and objectives: Patient-reported outcomes (PROs) are being implemented in clinical practice across different healthcare settings with varying purposes. Involving patients in reporting outcomes may increase their attention to symptoms and thereby support their self-management. The aim of the present study was to describe patients’ experiences with a web-based PRO system where patients complete a PRO questionnaire at home or in the outpatient clinic prior to a consultation. Moreover, the study aimed to explore how PROs influenced the interaction between patients and clinicians during the consultation.
Methods: Through participant observations of 9 consultations and 12 semi-structured interviews with patients after the consultation this interpretive description study explored patients’ experiences with the PROs system. The PRO included self-assessment on health-related quality of life, symptoms and wellbeing. Patients who visited the outpatient clinic at the Department of Renal Medicine at Aarhus University Hospital in the Central Denmark Region in February and March 2014 and in March and August 2015 were invited to participate. We used a convenience sampling approach to recruit patients who had completed at least two PRO questionnaires.
Results: The analysis revealed rudiments of PROs in clinical practice leading to an increased understanding of their chronic disease, patient-centred communication and an additional focus on psychosocial problems. However, the operational application of PROs in the outpatient clinic and also patient attitudes were substantial and crucial barriers for PROs as methods to achieve patient involvement and self-management.
Conclusion: The use of PROs in outpatient consultations may support patients' self-management by (a) encouraging patient-centred communication in the consultation, (b) legitimising talk about psychosocial problems and (c) increasing patient understanding of their disease. Yet, implementing PROs in clinical practice does not automatically involve patients and support their self-management. We suggest supplementary clinical initiatives to strengthen patient involvement and securing benefit from PROs.
TidsskriftEuropean Journal for Person Centered Healthcare
Sider (fra-til)359-367
Antal sider9
StatusUdgivet - aug. 2016

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