Piloting patient-reported outcome measures for evaluation of the Irish Chronic Disease Programme

Abstract

Abstract Background The Irish National Integrated Care Programme for Chronic Disease (ICPCD) aims to deliver end-to-end, patient-centred care across three clinical programmes; Heart, Respiratory and Diabetes. Patient-reported outcome measures (PROMs) are a means of objectively measuring changes in patients’ subjectively-perceived health status over time in response to services. As such, PROMs facilitate service monitoring and evaluation and are an important tool for the ICPCD to ensure optimal, patient-centred, value-based healthcare delivery. Methods To select the most appropriate PROMs instrument for use across ICPCD, comprehensive literature review was undertaken followed by key stakeholder consultation in winter 2022. Following consideration against a set of pre-determined criteria the EQ-5D-5L, a well-validated, reliable PROMs instrument, was selected as the most appropriate PROMs instrument for use. Study design involved pilot implementation of EQ-5D-5L in one ICPCD ambulatory care hub service followed by mixed methods evaluation of staff experience of the pilot. Results The pilot was conducted from April to June 2023 among a socio-demographically diverse sample of patients attending their first and last episode of care with the ICPCD diabetic patient education service in Galway. Following service attendance there was a significant aggregate improvement in self-reported overall health rating but no significant change in self-reported mobility, self-care, usual activities, pain/discomfort or anxiety/depression. Predominant staff concerns included staff and patient burden and the need for adequate staff resourcing and information technology support. Conclusions In conjunction with key national stakeholders findings from the pilot will be used to support the development of a PROMs implementation plan at scale for adoption across all ICPCD services. Ultimately national implementation will support the ongoing delivery of high quality patient-centred care within ICPCD services. Key messages • PROMs facilitate service evaluation and are an important tool for the Irish National Integrated Care Programme for Chronic Disease (ICPCD) to ensure optimal patient-centred healthcare delivery. • This pilot will support PROMs implementation at scale across ICPCD services and ultimately reinforce the ongoing delivery of high-quality, value-based, integrated healthcare.