Comparison of the Patient Enablement Instrument (PEI) with two single-item measures among Finnish Health care centre patients

Elina Tolvanen,Elise Kosunen,Tuomas H Koskela

doi:10.1186/s12913-019-4182-2

Elina Tolvanen, Elise Kosunen + Show 1 more

Open Access

https://doi.org/10.1186/s12913-019-4182-2

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Abstract

BackgroundThe Patient Enablement Instrument (PEI) is an established patient-reported outcome measure (PROM) that reflects the quality of appointments with general practitioners (GPs). It is a six-item questionnaire administered to the patient immediately after a consultation. The aim of this study was to evaluate whether a single-item measure could replace the PEI when measuring patient enablement among Finnish health care centre patients.MethodsTwo single-item measures, Q1 and Q2, were chosen for comparison with the PEI. Firstly, a pilot study with questionnaire testing and brief interviews with the respondents were performed in order to assess the content validity of the PEI and the single-item measures. Secondly, a questionnaire study after a single appointment with a GP was carried out in three health care centres in Western Finland in order to evaluate the construct and criterion validity of the single-item measures. A telephone interview was performed 2 weeks after the appointment in order to assess the test-retest reliability of the single-item measures. The sensitivity, specificity, and both positive and negative predictive values of Q1 and Q2 were calculated with different PEI score cut-off points.ResultsAltogether 483 patients with a completed PEI were included in the questionnaire study analyses. Altogether 149 and 175 patients had completed Q1 and Q2, respectively, both in the questionnaire and the telephone interview. The correlations between the PEI and Q1 and Q2 were 0.48 and 0.84, respectively. Both the single-item measures had a high sensitivity and a negative predictive value in relation to patients with lower PEI scores. The reliability coefficients were 0.24 for Q1 and 0.76 for Q2. The test-retest values of Q1, Q2, and the PEI were low.ConclusionsQ2 seems to be a valid and reliable measure of patient enablement. Q1 seems to be less correlated with the PEI, but it also has a high negative predictive value in relation to low enablement scores.

Highlights

The Patient Enablement Instrument (PEI) is an established patient-reported outcome measure (PROM) that reflects the quality of appointments with general practitioners (GPs)
The majority of the respondents found the questions important and relevant, and they had no problems when filling out the questionnaires, reflecting the good content validity of both the PEI and Q1
175 patients who participated in the telephone interview had a completed PEI score and had made no visits to any doctor in the interim period, and they were included in the test-retest analyses

Summary

Introduction

The Patient Enablement Instrument (PEI) is an established patient-reported outcome measure (PROM) that reflects the quality of appointments with general practitioners (GPs). It is a six-item questionnaire administered to the patient immediately after a consultation. The aim of this study was to evaluate whether a single-item measure could replace the PEI when measuring patient enablement among Finnish health care centre patients. The advantage for single-item measurements is that they are effortless and quick to answer. They require little space on a survey form. It is suggested that single-item measures are appropriate if the concept to be measured is sufficiently specific and unidimensional rather than multidimensional [4, 8]

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