Chapter 15 - Patient reported outcomes (PROs): Considerations for implementation in your ERAS program

Abstract

Patient-reported outcomes (PROs) are patient health measures reported directly by patients and can be reported via patient-reported outcome measures (PROMs). PROs are well-suited to measure the multiple domains and complex process of postoperative recovery and can help institutions monitor, understand, and compare patterns of recovery. When implementing PROs, the selection of a PROM should be guided by goals of the clinical application; study, or institutional resources informing the setting, mode, timing, and frequency of PRO collection; and instrument metrics such as intended use, measured concepts, scoring, content validity, responsiveness, recall period, response options, number of items, questionnaire length, and formatting. There are multiple treatment-specific PROMS that have been designed to measure postoperative outcomes and may be used in studies evaluating ERAS. ERAS studies measuring PROs have overall demonstrated improved PROs compared to non-ERAS perioperative care, although PROs specific to ERAS in gynecologic surgery remain underutilized.