Implementing Patient-Reported Outcome Measures into Clinical Practice Across NSW: Mixed Methods Evaluation of the First Year

Abstract

Use of patient-reported measures (PRMs) in healthcare is increasing internationally. In New South Wales (NSW) Australia the implementation of a system-wide PRMs program is underway. This program is an enabler for value based healthcare. We report an evaluation (2015/16) of this program’s first year. We evaluated the program using mixed methods. People living with chronic conditions from 18 sites across NSW completed PROMIS10 at all sites; DASS21 and CAT administered at selected sites depending on patient cohorts. PRM completion rates and mean scores were calculated. Stakeholder interviews were analysed using thematic analysis. PRM completion rates were high at baseline (69%) but suboptimal at follow-up time-points. Mean scores indicated people with back pain had worse physical health and stress compared to those with other conditions. People with alcohol or drug problems had worse mental health, disease symptoms, depression and anxiety compared to other conditions. Stakeholders reported collection of PRMs could improve health outcomes for patients, enhance service delivery, and reduce avoidable hospital admissions. Routine collection and use of PRMs can be implemented across NSW care settings. Several challenges need to be overcome to realise the full benefits of the PRM program and to improve follow-up completion rates.