TY - JOUR

T1 - Haematologists’ experiences implementing patient reported outcome measures (PROMs) in an outpatient clinic

T2 - a qualitative study for applied practice

AU - Thestrup Hansen, Stine

AU - Kjerholt, Mette

AU - Friis Christensen, Sarah

AU - Hølge-Hazelton, Bibi

AU - Brodersen, John

PY - 2019

Y1 - 2019

N2 - Background: The patient-doctor relationship is crucial to provide person-centred care, allowing the alleviation of symptom burden caused by disease or treatment. Implementing Patient Reported Outcome Measures (PROMs) is suggested to inform the decision-making process and lead to initiation of care. Yet there are knowledge gaps regarding how meaningful it is to incorporate PROMs in clinical settings. The aim of this study was to investigate haematologists’ experiences when PROMs were implemented in an outpatient setting. Methods: Fourteen participant observations, 13 individual interviews and three in-depth interviews were conducted with haematologists, guided by the qualitative methodology Interpretive Description. Analysis was inspired by Habermas’ critical theoretical framework. Results: The haematologists included were characterised by dichotomous experiences with PROMs, either resistant to or supporting their implementation. None were observed to elaborate on PROMs during consultations: instead, primary attention was spent discussing the hematological agenda dictated by the system. Conclusion: The use of PROMs for individualized care was linked with extensive uncertainties and PROMs were not requested by the haematologists. To improve individualized care, other approaches may be more suitable. If PROMs are to be incorporated into future clinical practice, they should be tested tothe specific patient group and involve relevant users.

AB - Background: The patient-doctor relationship is crucial to provide person-centred care, allowing the alleviation of symptom burden caused by disease or treatment. Implementing Patient Reported Outcome Measures (PROMs) is suggested to inform the decision-making process and lead to initiation of care. Yet there are knowledge gaps regarding how meaningful it is to incorporate PROMs in clinical settings. The aim of this study was to investigate haematologists’ experiences when PROMs were implemented in an outpatient setting. Methods: Fourteen participant observations, 13 individual interviews and three in-depth interviews were conducted with haematologists, guided by the qualitative methodology Interpretive Description. Analysis was inspired by Habermas’ critical theoretical framework. Results: The haematologists included were characterised by dichotomous experiences with PROMs, either resistant to or supporting their implementation. None were observed to elaborate on PROMs during consultations: instead, primary attention was spent discussing the hematological agenda dictated by the system. Conclusion: The use of PROMs for individualized care was linked with extensive uncertainties and PROMs were not requested by the haematologists. To improve individualized care, other approaches may be more suitable. If PROMs are to be incorporated into future clinical practice, they should be tested tothe specific patient group and involve relevant users.

KW - Applied research

KW - EORTC QLQ-C30

KW - Haematology

KW - OEQ

KW - Patient reported outcomes

KW - Qualitative study

U2 - 10.1186/s41687-019-0166-6

DO - 10.1186/s41687-019-0166-6

M3 - Journal article

C2 - 31884569

AN - SCOPUS:85077592777

VL - 3

JO - Journal of Patient-Reported Outcomes

JF - Journal of Patient-Reported Outcomes

IS - 1

M1 - 74

ER -