Using patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) in routine head and neck cancer care: What do health professionals perceive as barriers and facilitators?

Abstract

Patient-reported outcomes (PROs) are direct reports from patients about their health status. Patient-reported outcome measures (PROMs) are validated tools assessing PROs andcompleted by patients. Though commonly used in research, implementing PROMs into routine clinical care has been challenging. We aimed to examine health professionals' (HPs') perceptions of barriers and facilitators to PRO and PROM use in the routine care of head and neck cancer (HNC) patients. A custom survey was created, pilot-tested and disseminated to all HPs involved in the care of HNC patients in Western Sydney Local Health District, Australia. Participants were asked to rate the degree to which they believed the survey items were barriers or facilitators to routine PRO use by answering 'not at all', 'very little', 'quite a bit' and 'very much'. Of 129 HPs, 86% had never routinely used PROs. Key barriers perceived were low workplace awareness of PROs (73%), HPs' lack of knowledge on PRO use (63%) and lack of PROMs in patient preferred languages (63%). Insufficient time, staff and infrastructure to support routine PRO collection and non-integrated PROMs in patient electronic medical records were also highlighted. Top facilitators were time for PRO administration and interpretation (86%), clear definition of staff roles (84%) and automatic scoring and interpretation of PROMs (81%). This study highlighted key barriers and facilitators to PRO use in routine HNC patient care as perceived by HPs. The findings will be useful in guiding the successful and sustainable implementation of routine PRO collection in clinical settings.