Patient reported outcome measures in weight management service evaluation

Abstract

Background: Changes to National Health Service (NHS) commissioning (Department of Health, 2010) will increase the need for weight management services to demonstrate service effectiveness far beyond traditional variables of anthropometry and eating behaviours. Patient reported outcome measures (PROMs) can offer additional evidence of a service's effectiveness by measuring quality from the patient's perspective (The Information Centre for Health and Social Care, 2010). The aim of this study was to evaluate the use PROMS as a method of demonstrating effectiveness of a group weight management intervention. Methods: Participants who enrolled on a 10-week group weight management intervention (n = 38) between June to December 2010 were asked to select or report three goals (excluding weight loss) that they wished to achieve within the next 3–6 months of commencing the intervention. At completion of the intervention, participants were asked to rate how they progressed on achieving these goals on a five-point Likert item, ranging from ‘Not started’ to ‘Completed’. Results: Thirty-seven participants (97%) documented goals, with 110 goals reported in total. Participants rated their progress of achievement against 100 goals providing a 90% completion rate. Collectively, 18 different goals were nominated, with the five most common being: clothing to fit better (15%), feeling less tired/having more energy (15%), reduced joint pain (13%), decreased cholesterol (9%) and feeling better about myself (9%). In terms of goal progression and attainment, by the conclusion of the intervention, 12% rated as ‘not started’, 21% had ‘started but not half way’, 42% were ‘halfway there’, 17% were ‘nearly completed’ and 8% rated their goal as ‘completed’. Overall, 67% of participants rated that they were between ‘half-way there’ to ‘completed’ with their goals. Discussion: In this study, PROMs have been shown to be an effective method of demonstrating nontraditional variables of weight loss from the patient's perspective. A structured approach to gathering and analysing patient led goals, coupled with attainment scaling, has highlighted additional nonweight-related values experienced by patients. This is demonstrated by the 67% of participants who made adjustments to their lives throughout the 10-week programme reporting positive shifts in attainment of their personal goals. PROMs could also be considered a future tool to promote further innovations targeting user need more effectively. Conclusions: In the current NHS climate, with strong drives for the commissioning of patient centred, efficient and effective services, the use of PROMs within weight management services should be embraced. PROMs enhance the ability of services to demonstrate effectiveness to users and commissioners alike.