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Quality of Life Research
Published in: Quality of Life Research 11/2021

Open Access 01-11-2021 | Care | Special Section: Feedback Tools

Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings

Authors: Angela M. Stover, Lotte Haverman, Hedy A. van Oers, Joanne Greenhalgh, Caroline M. Potter, On behalf of the ISOQOL PROMs/PREMs in Clinical Practice Implementation Science Work Group

Published in: Quality of Life Research | Issue 11/2021

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Abstract

Purpose

Patient-reported outcome and experience measures (PROMs/PREMs) are well established in research for many health conditions, but barriers persist for implementing them in routine care. Implementation science (IS) offers a potential way forward, but its application has been limited for PROMs/PREMs.

Methods

We compare similarities and differences for widely used IS frameworks and their applicability for implementing PROMs/PREMs through case studies. Three case studies implemented PROMs: (1) pain clinics in Canada; (2) oncology clinics in Australia; and (3) pediatric/adult clinics for chronic conditions in the Netherlands. The fourth case study is planning PREMs implementation in Canadian primary care clinics. We compare case studies on barriers, enablers, implementation strategies, and evaluation.

Results

Case studies used IS frameworks to systematize barriers, to develop implementation strategies for clinics, and to evaluate implementation effectiveness. Across case studies, consistent PROM/PREM implementation barriers were technology, uncertainty about how or why to use PROMs/PREMs, and competing demands from established clinical workflows. Enabling factors in clinics were context specific. Implementation support strategies changed during pre-implementation, implementation, and post-implementation stages. Evaluation approaches were inconsistent across case studies, and thus, we present example evaluation metrics specific to PROMs/PREMs.

Conclusion

Multilevel IS frameworks are necessary for PROM/PREM implementation given the complexity. In cross-study comparisons, barriers to PROM/PREM implementation were consistent across patient populations and care settings, but enablers were context specific, suggesting the need for tailored implementation strategies based on clinic resources. Theoretically guided studies are needed to clarify how, why, and in what circumstances IS principles lead to successful PROM/PREM integration and sustainability.
Appendix
Available only for authorised users
Footnotes
1
We use the term “facilitators” in this paper series to designate the implementation support person working with clinics, rather than the classic use of the word in IS to mean enablers, such as clinic resources.
 
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Metadata
Title
Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings
Authors
Angela M. Stover
Lotte Haverman
Hedy A. van Oers
Joanne Greenhalgh
Caroline M. Potter
On behalf of the ISOQOL PROMs/PREMs in Clinical Practice Implementation Science Work Group
Publication date
01-11-2021
Publisher
Springer International Publishing
Keyword
Care
Published in
Quality of Life Research / Issue 11/2021
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-020-02564-9

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