Patient-reported Experience Measures Research Articles

Exploring the factors impacting choice and quality of overnight private hospital stays and consumer perspectives on patient reported experience measures (PREMs) in Australia: a qualitative interview study

ObjectivesPatient reported experience measures (PREMs) are tools often utilised in hospitals to support quality improvements and to provide objective feedback on care experiences. Less commonly PREMs can be used to support consumers choices in their hospital care. Little is known about the experience and views of the Australian consumer regarding PREMs nor the considerations these consumers have when they need to make decisions about attending hospital. This study aimed to explore consumer awareness of PREMs, consumer attitudes towards PREMs and the utility of PREMs as a decision-making tool in accessing hospital care.MethodsQualitative study involving semi-structured interviews conducted over the phone. Participants (n = 40) were recruited from across Australia and purposively sampled according to key characteristics: holding private health insurance, > 30-years of age, may have accessed private hospital care in the past year, variety of educational and cultural backgrounds, and if urban or rural residing. Interviews were audio-recorded, transcribed, and analysed thematically.ResultsFour overarching themes and six subthemes were identified from the data. Major findings were that prior awareness of PREMs was limited; however, many had filled in a PREM either for themselves or for someone they cared for following a hospital stay. Most respondents preferred to listen to experience of self or family/friends or the recommendation of their physician when choosing a hospital to attend. Participants appeared to be more interested in the treating clinician than the hospital with this clinician often dictating the hospital or hospital options. If provided choice in hospital, issues of additional costs, timeliness of treatment and location were important factors.ConclusionWhile PREMs were considered a possible tool to assist in hospital decision-making process, previous hospital experiences, the doctor and knowing up-front cost are an overriding consideration for consumers when choosing their hospital. Consideration to format and presentation of PREMs data is needed to facilitate understanding and allow meaningful comparisons. Future research could examine the considerations of those consumers who primarily access public healthcare facilities and how to improve the utility of PREMs.

Experience of care from the perspectives of inpatients with palliative care needs: a cross-sectional study using a patient reported experience measure (PREM)

BackgroundImproving palliative care for inpatients is urgently needed. Data from patient-reported experience measures (PREM) can assist in identifying areas for focused improvement. This study aimed to describe patient reported experience of care in inpatients with palliative care needs, to inform a baseline understanding of care experience and identify key areas for improvement.MethodsCross-sectional study design where inpatients with palliative care needs were invited to complete ‘consideRATE,’ a patient reported experience measure of care, over six months in 2022. Inpatients with palliative care needs receiving care on an oncology, general medicine/renal and general medicine/respiratory ward (n = 3) at an Australian metropolitan hospital were screened for eligibility. Carers could provide proxy responses where inpatients were unable to participate. Descriptive statistics were used to analyse quantitative ratings, whilst free text responses were analysed using integrated thematic analysis.ResultsOne-hundred and twenty participants (108 patients and 12 carers) completed consideRATE. The questions with the highest number of ‘very good’ responses were attention to symptoms, attention to feelings and attention to what matters most; the questions with the lowest number of ‘very good’ responses was attention to patients’ affairs, what to expect, and the environment of care. Almost half (n = 57, 48%) indicated that attention to patients’ affairs ‘did not apply’ to their inpatient stay. Analysis of 532 free text responses across 8 questions highlighted the importance of feeling supported, feeling informed, feeling heard and navigating the clinical environment.ConclusionEnabling inpatients with palliative care needs to provide feedback about their experience of care is one method of ensuring improvements matter to patients. Supporting clinical teams to understand and use these data to make tailored improvements is the next step in this multi-phase research.

Engaging primary care professionals in OECD’s international PaRIS survey: a documentary analysis

Healthcare professionals have first-hand experience with patients in clinical practice and the dynamics in the healthcare system, which can be of great value in the design, implementation, data analysis and dissemination of research study results. Primary care professionals are particularly important as they provide first contact, accessible, coordinated, comprehensive and continuous people-focused care. However, in-depth examination of the engagement of health professionals in health system research and planning activities—how professionals are engaged and how this varies across national contexts- is limited, particularly in international initiatives. There is a need to identify gaps in the planning of engagement activities to inform the design and successful implementation of future international efforts to improve the responsiveness of health systems to the changing needs of patients and professionals. The aim of this study was to explore how primary care professionals were engaged in the design and implementation plans of an international health policy study led by the Organisation for Economic Co-operation and Development (OECD). The OECD’s international PaRIS survey measures and disseminates information on patient-reported outcome and experience measures (PROMs and PREMs) of people living with chronic conditions who are managed in primary care. A documentary analysis of 17 written national implementation plans (country roadmaps) was conducted between January and June 2023. Two reviewers independently performed the screening and data abstraction and resolved disagreements by discussion. We reported the intended target primary care professionals, phase of the study, channel of engagement, level of engagement, and purpose of engagement. All 17 countries aimed to engage primary care professionals in the execution plans for the international PaRIS survey. While organisations of primary care professionals, particularly of family doctors, were the most commonly targeted group, variation was found in the timing of engagement activities during the different phases of the study and in the level of engagement, ranging from co-development (half of the countries co-developed the survey together with primary care professionals) to one-off consultations with whom. International guidance facilitated the participation of primary care professionals. Continuous collaborative efforts at the international and national levels can foster a culture of engagement with primary care organisations and individual professionals and enhance meaningful engagement of primary care professionals.

2023 Kidney Patient Reported Experience Measures

Nick Palmer outlines the results of the 2023 Patient Reported Experience Measures

Commentary- Bridging the Gap: The Impact of Bowel Management Programs on Daily Life in Pediatric Colorectal Disease

BackgroundThis commentary discusses the social impact of bowel management programs (BMPs) on children with colorectal diseases, including anorectal malformations (ARM), Hirschsprung disease (HD), functional constipation (FC), and spina bifida. Previous studies focused on functional outcomes, but this study bridges the gap to daily life experiences. MethodsThe study examined children's experiences in BMPs, focusing on school participation, vacation ability, and overall patient experience. Cleanliness, defined as fewer than one stool soiling episode per week, was achieved by 70% of participants. ResultsPositive patient experiences were linked to achieving stool cleanliness, regardless of the management method. Invasive methods like enemas did not negatively affect experiences if cleanliness was maintained. Validated patient-reported experience measures (PREMs) and patient-reported outcomes measures (PROMs) were used, though the median age of 8.9 years posed limitations. ConclusionThe commentary highlights the significance of stool cleanliness in improving patient experiences and supports the effectiveness of various BMP methods. Future research should include longitudinal follow-ups to assess BMP durability and gather data from older children.

Patient Surveys Are Used Most Often to Assess Health Care Innovations, Rigorous Methods Are Less Common.

The Agency of Healthcare Research and Quality Healthcare Innovations Exchange (IE) was developed to collect and report on innovative approaches to improving health care. The team reviewed 348 IE innovations including patient-reported satisfaction or experience measures. Innovations most often measured overall rating of care (61% of innovations), followed by access (52%) and provider-patient communication (12%). More than half used patient satisfaction surveys (n = 187) rather than patient experience surveys (n = 64). Innovations using patient experience surveys more often measured specific aspects of patient care, for example, access, versus a general overall rating of care. Most innovations using patient experience surveys administered nonvalidated, homegrown surveys, with few using the Agency of Healthcare Research and Quality-endorsed, psychometrically-tested CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey. The most common study design was postimplementation-only (65%), highlighting that methodological rigor used to assess patient-centeredness in the IE is low. Broad use of patient experience surveys and more rigorous evaluation study designs has increased some over time but is still lacking.

Measurement properties of the Portuguese version of the rheumatoid arthritis patient-reported experience measure (CQRA-PREM): a cross-sectional single center study

Aims: to test the measurement properties of the Portuguese version of the Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) for patients with rheumatoid arthritis (RA). Methods: This cross-sectional clinical field study recruited adult patients with RA during rheumatology appointments of a Portuguese rheumatology center. Patients completed the Portuguese version of CQRA-PREM, composed of 7 domains and 24 questions. Sociodemographic characteristics, symptoms/disease duration, current treatment, Pain-Visual Analog Scale (VAS), Patient Global Assessment (PGA)-VAS and Health Assessment Questionnaire (HAQ) were also collected from the patient. Disease Activity Score for 28 joints with C-reactive Protein (DAS28-CRP) was recorded by the rheumatologist. The assessment of CQRA-PREM measurement properties followed the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) recommendations. Results: A total of 61 patients with RA were included. The domains in which patients showed better experience were the “Needs and preferences”, followed by “Coordination and Communication”. The domain “Information, education and self-care” was an identified area of improvement for providing patient-centered care. Ceiling effects were found in four domains of the CQRA-PREM. Internal consistency of all domains was considered good (α>0.7). Homogeneity was considered good for each question in all domains analyzed (0.30≤rp≤0.70). The divergent validity of the PREM was good, revealing that the domains were not correlated (Pain-VAS, HAQ, DAS28-CRP) or only weakly (PGA-VAS) correlated with clinical outcomes. Conclusions: The CQRA-PREM showed acceptable measurement properties and is a useful tool for evaluating quality of healthcare provided in daily practice, as perceived by RA patients in Portugal.

Exploring patient perspectives: orthognathic surgery outcomes and experiences assessed by patient-reported outcome measures and patient-reported experience measures

Evaluating the effectiveness of orthognathic treatment can be difficult. To address this issue, patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) have been proposed as valuable instruments for understanding the quality of healthcare from the patients’ standpoint. Therefore, the aim of this project was to employ PROMs and PREMs questionnaires to capture the patients’ perspectives regarding their experience during the orthognathic treatment process, as well as their perception of their postoperative state. Preoperative and postoperative questionnaires were offered to patients at consenting appointment and at various timepoints after the surgery. The assessment of statistical relationships was carried out by means of Fisher’s exact test. A total of 64 preoperative and 126 postoperative responses were received. The primary motivators for pursuing the surgery were the improvement of facial and dental aesthetics, as well as increased satisfaction with photographic and video appearances. These three factors were also cited as the most important postoperative benefits. Of the respondents, 58% reported experiencing altered sensation to the lower lip at the 24-month follow up (p = 0.02); however, the affected patients reported that this did not have an impact on their daily activities. The use of PROMs and PREMs to appraise the quality of life constitutes a valuable method for surgeons to gauge their treatment efficacy. Above all, such tools are particularly useful for evaluating patient satisfaction, which is the ultimate objective of any treatment.

Patient reported experience measures: an assessment of the in-patients in a tertiary care teaching hospital

Patient reported experience measures: an assessment of the in-patients in a tertiary care teaching hospital

Near real-time patient experience feedback with data relay to providers: a systematic review of its effectiveness.

Near Real-Time Feedback (NRTF) on the patient's experience with care, coupled with data relay to providers, can inform quality-of-care improvements, including at the point of care. The objective is to systematically review contemporary literature on the impact of the use of NRTF and data relay to providers on standardized patient experience measures. Six scientific databases and five specialty journals were searched supplemented by snowballing search strategies, according to the registered study protocol. Eligibility included studies in English (2015-2023) assessing the impact of NRTF and data relay on standardized patient-reported experience measures as a primary outcome. Eligibility and quality appraisals were performed by two independent reviewers. An expert former patient (Patient and Family Advisory Council and communication sciences background) helped interpret the results. Eight papers met review eligibility criteria, including three randomized controlled trials (RCTs) and one non-randomized study. Three of these studies involved in-person NRTF prior to data relay (patient-level data for immediate corrective action or aggregated and peer-compared) and led to significantly better results in all or some of the experience measures. In turn, a kiosk-based NRTF achieved no better experience results. The remaining studies were pre-post designs with mixed or neutral results and greater risks of bias. In-person NRTF on the patient experience followed by rapid data relay to their providers, either patient-level or provider-level as peer-compared, can improve the patient experience of care. Reviewed kiosk-based or self-reported approaches combined with data relay were not effective. Further research should determine which approach (e.g. who conducts the in-person NRTF) will provide better, more efficient improvements and under which circumstances.

Outcomes or Experiences — What Do Patients Value More When Evaluating Medical Teams?

As quality-based payment proliferates worldwide, patient outcomes and patient experience measures are increasingly prioritized. However, little is known about whether patients value outcomes or experiences more when choosing a medical team. In a survey of patients across four European countries — France, Italy, Spain, and the United Kingdom — 998 patients with diagnoses of breast cancer, diabetes, inflammatory bowel disease, depression, or arthritis rated the importance of patient-reported outcome measures (PROMs) validated by the International Consortium of Health Outcomes Measurement relative to patient-reported experience measures (PREMs), which lack a standard instrument across Europe. The authors randomized the order of questions on PROMs and PREMs, and they further randomized the order of 10 indicators of outcomes and experiences to blunt priming effects. Although patients considered both outcomes and experiences important, on average 83.0% of patients considered PROMs more important than PREMs for choosing a medical team, with PROMs more important among 86.9% of the breast cancer sample, 82.6% in diabetes, 80.8% in inflammatory bowel disease, 79.4% in depression, and 86.7% in arthritis. Older patients were more likely to consider outcomes more important than experiences. These results suggest that outcomes and experiences are not viewed as the same by patients and that PROMs may need to be integrated to a larger extent into current payer efforts involving incentives to improve quality; these efforts could include value-based payment models that reward or put payments at risk based on quality performance.

Post-Donation Evaluation: Emotional Needs for Social Connection and Social Support among Living Kidney Donors-A Systematic Review.

Evaluation of post-nephrectomy social health in living kidney donors is essential. This systematic review examines their emotional need for social relatedness post-donation. Following the PRISMA guidelines, we systematically searched Scopus, CINAHL, and PsycINFO. Among the screened records, 32 quantitative and 16 qualitative papers met the inclusion criteria. Quantitative research predominantly utilized questionnaires featuring generic items on social functioning. However, a minority delved into emotional and social dimensions, aligning with qualitative studies emphasizing the importance of social connection and perceived social support post-donation. Specifically, post-donation changes in connecting with others encompass a sense of belongingness, heightened autonomy, shifts in concern for the recipient's health, and continued care by shielding the recipient from personal health issues. Social acknowledgment and social support from both close and extended networks are reported as relevant for recovery after nephrectomy. These findings underscore the necessity for targeted measures of emotional needs and social functioning to effectively assess post-donation adjustment. They also inform the identification of key health themes for kidney donor Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) questions.

High Quality of Care Delivery Improves Patient Satisfaction and Quality of Life Outcomes After Breast Augmentation.

Breast augmentation is one of the most common aesthetic procedures worldwide. Most studies have focused on evaluating the outcome with validated patient-reported outcome measures (PROMs) and factors that may influence them. However, the influence of care delivery, which can be measured with patient-reported experience measures (PREMs), is rarely considered in studies of breast augmentation patients. In this study we aimed to evaluate the associations between PREMs and PROMs in patients who underwent breast augmentation. A multicenter cohort study was conducted in breast augmentation patients. Patients completed PREMs, including items such as communication between physician and patient, expectation management, welcome, and hygiene, and the BREAST-Q PROM (satisfaction with breasts and psychosocial, physical, and sexual well-being) preoperatively and 6 months postoperatively. Regression analyses were performed to investigate the associations between PREMs and PROMs. Overall, 329 patients were included between 2018 and 2022. Univariate regression analysis showed a positive association between PREM and PROM scales. The feeling of being heard (B = -38.39 and B = -18.90), the opportunity to ask questions (B = -9.21), and trust in their physician (B = -39.08) had the highest association with change in the 4 BREAST-Q scales. The multivariable regression analysis showed that the variance in PROMs related to changes in PREMs (19%) was little influenced by patient characteristics (1%). Patient outcomes are more positive after breast augmentation when patients feel they are being heard, have the opportunity to ask questions, and have trust in their physician. Future studies should be targeted at optimizing patient-reported experience to investigate whether this improves patient-reported outcomes.

Patient-driven research priorities for patient-centered measurement

BackgroundPatient-centred measurement (PCM) emphasizes a holistic approach wherein the voices of patients are reflected in the standardized use of patient-reported outcome and experience measures and are represented throughout the continuum of measurement activities. Given the challenges of routinely integrating patient self-reports into clinical care decisions, the perspectives of all healthcare system stakeholders, especially patients, is necessary to advance the science of PCM. The purpose of the analysis we report on here was to identify patient-driven research priorities for advancing the science of PCM.MethodsWe analyzed data from seven focus groups that were conducted across British Columbia, Canada and that included a total of 73 patients, using qualitative inductive analysis and constant comparative methods.ResultsWe found that the patients conveyed a desire for PCM to contribute to healthcare decisions, specifically that their individual healthcare needs and related priorities as they see them are always front and centre, guiding all healthcare interactions. The patients’ commentaries highlighted intersecting priorities for research on advancing the science of PCM that would help transform care by (1) enhancing the patient-provider relationship, (2) giving voice to patients’ stories, (3) addressing inclusivity, (4) ensuring psychological safety, (5) improving healthcare services and systems to better meet patient needs, and (6) bolstering healthcare system accountability.ConclusionsThese priorities provide direction for future research efforts that would be positioned to make progress towards better health, better care, and better use of resources for individuals and for society.

Psychometric validation of a patient-reported experience measure for older adults attending the emergency department: the PREM-ED 65 study

IntroductionOptimising emergency department (ED) patient experience is vital to ensure care quality. However, there are few validated instruments to measure the experiences of specific patient groups, including older adults. We...

Deferring diagnostic evaluation of suspected deep vein thrombosis using direct oral anticoagulant or low-molecular-weight heparin as a single dose anticoagulant: A prospective real-world study in a regionwide care pathway

BackgroundPatients with suspected deep vein thrombosis (DVT) are typically referred to the emergency department for immediate evaluation. To enhance efficiency, our hospital implemented a regional, general practitioner (GP)-driven DVT care pathway, deferring diagnostic evaluation to a scheduled outpatient DVT clinic appointment the following day. Patients receive a single dose anticoagulant from their GP to prevent thrombosis progression while awaiting diagnostic workup. This prospective study aimed to evaluate the safety and patient preferences regarding the DVT care pathway and the type of single dose anticoagulant (low-molecular-weight heparin (LMWH) vs. direct oral anticoagulant (DOAC)). MethodsPatients enrolled in the DVT care pathway between June 2021 and July 2023 were eligible. Until July 2022, LMWH was administered, and thereafter, the protocol recommended DOAC as the single dose anticoagulant. Patients completed questionnaires, incorporating patient-reported outcome and experience measures (PROMs/PREMs), during their DVT clinic visit and after five days. The primary endpoint was bleeding events within 72 h of receiving the single dose anticoagulant. ResultsOf 460 included patients, 229 received LMWH and 231 received DOAC as the single dose anticoagulant. DVT was confirmed in 24.8 % of patients. No major or clinically relevant non-major bleeding were reported. LMWH was associated with more minor bleedings (22.3 % vs. DOAC 13.4 %), primarily attributed to injection site hematomas. Patients reported high satisfaction with the DVT care pathway (96.5 %) and generally preferred DOAC over LMWH. ConclusionDeferring diagnostic evaluation for DVT using a single dose of either LMWH or DOAC in a real-world population is deemed safe. Considering practical advantages, patient preferences, and fewer skin hematomas, we favor DOACs as the single dose anticoagulant in this care pathway.

Partnership working to drive person-centred change: a case study

This article puts the stroke survivor's voice at the centre of improvement, by highlighting the development, challenges and rollout of the patient-reported experience measures pilot survey created by the NHS England and the Stroke Association. The aim of this pilot survey was to test the feasibility, methodology and acceptability of a national survey of patient experience across the whole stroke pathway.

Therapeutic utilization in chronic lymphocytic leukemia: A cross-sectional analysis of the Lymphoma Coalition’s 2022 Global Patient Survey.

e19026 Background: Chronic Lymphocytic Leukemia (CLL) is a highly prevalent disease with heterogenous prognostic trajectories. With a multitude of treatment options, we sought to explore therapeutic utilization trends from a global perspective in order to gain a more in-depth understanding of how different treatment regimens are utilized in different health systems. Methods: In 2022, The Lymphoma Coalition designed and globally deployed a survey to patients with lymphoma and CLL in order to gather patient reported outcomes and patient reported experience measures. Data were collected and enumerated with relevant contingency analyses performed to determine associations with a particular treatment regimen in the context of CLL. Results: The entire cohort of patients with CLL was 1289. The median age of the cohort was 65 and ranged from 26 to 97 years old. Biological sex was equally distributed with 50.5% of respondent indicating that they were female. Respondents were derived from 29 countries. The top three contributors to each region were China (50%), Australia (25%) and New Zealand (18%) for Asia-Pacific (N = 227); France (50%), Italy (13%) and Sweden (7%) for Europe (N = 950); Canada (75%) and The United States (25%) for North America (N = 112). Of those, 636 indicated that they received at least one therapy. The use of chemo-immunotherapy was most common (42%) followed by targeted therapy (32%), immunotherapy alone (18%), and chemotherapy alone (16%). Neither age nor biological sex was a significant predictor of therapy. Europe had the highest rates of chemo-immunotherapy utilization (45%) with North America and Asia-Pacific indicating 32% respectively (p = 0.01). Targeted therapy was used at a higher rate in North America (45%) but failed to demonstrate a significant difference against Asia-Pacific and Europe (31%); (p=0.10). Both immunotherapy and chemotherapy alone failed to demonstrate significant differences across regions. Conclusions: The data support that the majority of patients with CLL who require treatment are most likely to receive combination chemo-immunotherapy utilizing rituximab. However, we acknowledge that the data presented here is two years old and that the use of targeted molecular therapy is likely increasing. We found it reassuring that we could not identify any biases in the administration of the therapeutic regimens across the demographics of age and biological sex. Our research in this space will continue as we have deployed the 2024 version of the Global Patient Survey and have focused on increasing respondent participation from North America. With this new data, we plan on producing a time-dependent model to investigate how emerging therapies enter and expand in the CLL therapeutic space.

#3012 Great impact of the results of PREMs and PROMs in all stages of chronic kidney disease. Analysis of 281 patients

Abstract Background and Aims In recent years, there has been a growing interest in the use and relevance of Patient-Reported Outcomes Measures (PROMs) and Patient-Reported Experience Measures (PREMs). The main objective of the study is to analyze scores in quality of life, anxiety, depression, and functional capacity using tests that assess PREMs and PROMs in patients at different stages of chronic kidney disease (CKD). Method Multicenter, cross-sectional, observational, non-interventional study with 281 patients (84 on hemodialysis, 48 on peritoneal dialysis, 50 with kidney transplant, 50 with advanced CKD, and 49 patients with CKD stages 1-2). Two professionals conducted interviews for data collection from all patients. Collected data: For PROMs: PFS (Piper Fatigue Scale), HADS (Hospital Anxiety and Depression Scale), FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue Scale), SF-36, VAS (Visual Analogue Scale). For PREMs - PACIC test (Patients' Assessment of Chronic Illness Care), in addition to other comorbidity indices and laboratory analyses. ANOVA statistical analysis was used for group comparison. Results Although patients showed significant differences in age and comorbidities, our analysis shows that the most PROMs do not discriminate between different stages of CKD. The PROMs that most discriminate between different stages of CKD are those related to the Piper Fatigue Scale test. PREMs, analyzed using the PACIC scale, do achieve said discrimination (Table 1). Conclusion The analysis of PROMs and PREMs show the significant impact that CKD has on health-related quality of life. Some PROMs can discriminate between different stages of CKD, but the most effective ones are PREMs, which are an indirect indicator of the quality of care received, contributing to patient involvement in decision-making and empowerment.

#1204 Measuring needling experience: development and validation of the Needling Patient Reported Experience Measure (NPREM)

Abstract Background and Aims Most people on haemodialysis rely on having reliable access to their vascular system, often via surgically created arteriovenous fistula or graft. At the beginning of each dialysis session, needles must be inserted. While ‘needling’ is a key step, an annual UK survey shows that needling is one of the lowest scoring areas of reported experience for individuals receiving haemodialysis in a kidney centre or satellite unit. Qualitative research indicates that needling can be painful and cause anxiety. Although an emerging area of research, no validated measures exist which assess patient reported experience of needling. We aimed to develop a questionnaire which reliably measures needling experience. The Needling Patient Reported Experience Measure (NPREM) was developed over multiple phases consisting of qualitative interviews with patients, item generation involving a multidisciplinary expert group including experts by experience, cognitive interviewing and pilot testing. Here we report the results of the final validation phase. Methods Seven NHS kidney centres participated in the validation phase (aiming for 500 participants). Between February-April 2023, participants completed either online or paper versions of the questionnaire. A subset of participants (aiming for 80-120) completed a follow-up questionnaire pack (NPREM, Change of Circumstances) 2-4 weeks after the first to assess the reliability of the scale over time. Analyses included a full evaluation of the scale psychometric properties and factor analyses to assess dimensional structure. Correlations with other validated measures (Vascular Access Quality of Life [VASQoL], EuroQol 5 Dimension [EQ5D-5L], and Patient Activation Measure [PAM]) were used to assess the convergent and divergent validity of the NPREM. Results 468 people participated (sample characteristics: male 66%, mean age 66 years (SD 14), White 75%, access via fistula 95%, first access 76%), of which 99 completed the follow-up. Overall, the NPREM showed good internal consistency (Cronbach's alpha = 0.94) and moderate to strong inter-item correlations. Factor analyses indicated that needling experience was a unidimensional construct, with one strong, main factor. Follow-up scores were strongly correlated (r = 0.89) with participants’ initial NPREM responses, demonstrating high reliability. Evidence of convergent validity was seen in the strong correlations between the NPREM and 1) the VASQoL (r = 0.60) and 2) the Overall Needling Experience question (r = 0.79). NPREM did not correlate with the EQ-5D (r = −0.31), the EQ-5D overall health (r = 0.24) or PAM (0.17), demonstrating divergent validity. The research team reviewed all items and themes reaching a consensus on items included, resulting in the validated 28-item NPREM (v 1.0), across five themes of care (Communicating with the Team, My Fistula/Graft and Needling, Steps in Needling, Working Together, My Personal Experience) plus Overall Needling Experience. Conclusion These results indicate that the NPREM offers a robust needling-specific tool to measure patient experience in those receiving haemodialysis. It addresses a gap by offering a way for kidney care providers to assess needling experience, both as a whole and across themes of care, which may facilitate meaningful service improvements. When published, the NPREM will be publicly available and free to use.