Abstract
Having been a national advocate for the use of patient reported outcome measures (PROMs) in Child and Adolescent Mental Health Services (CAMHS) in the UK for the last decade, I have become increasingly concerned that unless the potential iatrogenic impact of widespread policy requirement for use of PROMs (Department of Health, Children and Young People’s Health Outcomes Strategy, 2012) is recognised and addressed their real potential benefits (Sapyta et al., J Clin Psychol 61(2):145–153, 2005) may never be realized. Drawing on examples from PROMs implementation in CAMHS in the UK (Wolpert et al., J Ment Health 21(2):165–173, 2012a; Child Adolesc Mental Health 17(3):129–130, 2012b). I suggest key ways forward if PROMs are to support best clinical practice rather than undermine it.
Highlights
Patient reported outcome measures (PROMs) refer to any questionnaire completed by those using services that is used to try to assess whether there has been improvement in one or more domains relevant to the outcome of treatment
As part of the CAMHS Outcomes Research Consortium (CORC), a learning collaboration of Child and Adolescent Mental Health Services (CAMHS) across the UK and Europe, committed to using PROMs to inform service improvement, I and others have been instrumental in recommending use of key measures such as the Strengths and Difficulties Questionnaire to assess patients’ wellbeing and symptoms at the start and outcome of treatment
Children and Young People’s Improving Access to Psychological Therapies (CYP IAPT), a national UK initiative to ‘‘transform CAMHS’’ currently being rolled out to around 60 % of the country, has at its heart a commitment to implementation of PROMs and there is feedback from clinicians and service users involved of the use of the approach recommended to directly inform their clinical work: ‘‘It means if we go off track or get a bit lost along the way, we can both figure out how to find the way back again.’’ Young person from YoungMinds’ Very Important Kids Group reporting on experience of the CYP IAPT mode’’ (O’Herlihy 2013; Porter 2010 p. 3)
Summary
Patient reported outcome measures (PROMs) refer to any questionnaire completed by those using services (in the case of child mental health services this includes parents and carers as well as children and young people) that is used to try to assess whether there has been improvement in one or more domains relevant to the outcome of treatment. PROMs may, for example, measure change in symptoms or impact of difficulties on the young person’s life and/or sense of wellbeing. PROMs should be distinguished from clinician rated outcome measures (CROMs) which are clinician completed questionnaires relevant to assessing treatment outcomes. PROMs should be distinguished from patient reported experience measures (PREMs) which measure the patient’s satisfaction with a service they received but not the ‘‘outcome’’ of the service as such
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