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Creating guidance for the use of patient reported outcome measures (PROMS) in clinical palliatieve care.

Vliet, L.M. van, Harding, R., Bausewein, C., Payne, S., Higginson, I.J. Creating guidance for the use of patient reported outcome measures (PROMS) in clinical palliatieve care. BMJ Supportive & Palliative Care: 2014, 4(1), p. 113. Abstract: 10th Palliative care congress, 12–14 March, 2014, Harrogate, UK.
Introduction: Routine use of Patient Reported Outcome Measures (PROMs) in clinical practice can influence care but is not always achieved. One reason for this seems to be a lack of guidance on how to use PROMs in palliative care practice. This project aimed to provide such guidance.
Aim(s) and method(s): The 8-steps of implementing PROMs in clinical practice proposed by the International Society for Quality of Life Research were used as a framework. Recommendations within each step were created based on several sources including the booklet ‘Outcome Measures in Palliative Care: The Essentials’ and the EAPC White paper Outcome Measures.
Results: For the following steps, recommendations (including the provided examples) were created: i) identify the goals for collecting PROMs (e.g. screening versus monitoring of changes); ii) select patients, setting and timing of assessment (e.g. assess families' own needs); iii) determine which questionnaire to use (e.g. choose questionnaire based on evidence); iv) choose a mode for administering/scoring the questionnaire (e.g. self-administration versus computer-administration); v) design processes for reporting results (e.g. share results with patient/practitioners); vi) identify aids to facilitate score interpretation (e.g. determine the minimum clinically important difference); vii) develop strategies for responding to identified issues (e.g. integrate PROM data with other clinical data); viii) evaluate the impact of measuring PROMs on practice (e.g. conduct benchmarking).
Conclusion(s): As PROMs are increasingly used in palliative care, the proposed guidance is essential and timely. Future work will integrate this guidance with more questionnaire-specific guidance to optimise its usability and impact in clinical care.