Reported Experience Measures Research Articles

Australian adaptation and external validation of Commissioning for Quality in Rheumatoid Arthritis-RA-Patient Reported Experience Measure (CQRA-RA-PREM).

To evaluate the reliability and validity of an adapted Commissioning for Quality in Rheumatoid Arthritis-RA-Patient-Reported Experience Measure (CQRA-RA-PREM) for assessing care experience in an Australian rheumatology outpatient cohort. Individual patient interviews were performed to check the language and completion time of the CQRA-RA-PREM before modification. Australian Rheumatology Association Database (ARAD) participants completed the CQRA-PREM-Australian version (CQRA-PREM-AU) (22 items, 5 domains), disease activity measure (RAPID-3, BASDAI) and Assessment of Quality of Life (AQOL-6D) index. Exploratory factor analysis (EFA) assessed item correlation. Cronbach's α assessed internal consistency. Individual patient interviews (n = 8, 62% male, mean age 50 years, mean disease duration 4.5 years) informed CQRA-RA-PREM modification. The ARAD survey response rate was 707/1124 (63%); 459 (65%) RA, 134 (19%) PsA, 114 (16%) AS; 67% female, mean age 62 years, mean disease duration 22 years. The median instrument completion time was 299 s (interquartile range 284-414). Scoring of responses allowed an averaged overall score. EFA extracted five factors: all items loading similarly onto factor 1, indicating validity of the overall score. The CQRA-PREM-AU score correlated with the AQOL-6D score (ρ = 0.23, P < 0.01); partial correlation with disease activity was not significant (ρ = 0.03, P = 0.45), indicating divergent validity. Reliability was comparable across disease subgroups (Cronbach's α >0.94). The mean overall score did not differ by disease subgroup [4.1 (s.d. 0.6, P = 0.73) and there was no floor/ceiling effect. CQRA-PREM-AU is a valid and reliable instrument to measure self-reported care experience in Australian rheumatology patients and may be interpreted as an average overall numerical score.

Cardiovascular disease patient reported experiences with a web-based, interactive, clinically integrated cardiac rehabilitation program

Abstract Funding Acknowledgements Type of funding sources: None. Background/introduction Patient reported experience measures (PREMS) encompasses a person’s interactions within the healthcare system. Understanding the patient experience is key to quality patient-centered care, and evaluating these experiences is essential to improving clinical outcomes and health care quality. Cardiac rehabilitation (CR) programs contribute to redressing cardiovascular disease (CVD) morbidity and mortality by slowing the progression of CVD and restoring quality of life. There is consensus that CR suboptimal attendance and completion is multifactorial, and that different causes are involved. Thus, evaluating patient experience to improve CR program attendance and completion and reduce the burden of CVD is essential. Method A retrospective descriptive survey design was used for patients ≥18 years, who were enrolled and active with the interactive, and clinically integrated web-based program for their CR between July 2021 to December 2022. The primary outcome was patient experience, and the aim was to evaluate this experience. Results Of the 54 enrolled patients, 16 met the inclusion criteria and received an online survey link. Of these 9 (56.3%) responded. Most respondents were aged between 60-70 years (55.6%) and male (77.8%). Seven (77.8%) did a web-based program only, and hybrid (combined web-based and centre CR) were two, (22.2%). The main reasons for choosing this mode of delivery were restrictions relating to the COVID-19 pandemic (66.7 %), and/or geographical isolation and work commitments (33.3%). Most stated that they participated in their goal setting (89%), and 77.8% achieved these goals. Program completion was reported by 77.5% of patients, with 7.89 (SD 4.12) mean weeks completed. Information delivered in the education sessions was clear and easy to understand, contributing to positive lifestyle changes as reported by 77.7% of patients. All patients reported increased confidence across the CR health domains and being treated with respect and dignity. Regarding Phase 3 CR, extended ongoing outpatient attendance and exercise programs, 77.9% reported working with their GP and practice nurse to maintain lifestyle changes. Overall patients reported a positive experience from the web-based CR program stating, "I found this program to be very beneficial and would strongly recommend it to people having heart ops. Pity about covid stopping me attending face to face sessions. The phone and internet support was top notch". Conclusions Patients reported a high level of satisfaction with the education received and respect and dignity shown via a web-based CR program. This is fundamental to engagement with the program, behavior change and improved clinical outcomes in particular for patients with no access to center-based CR due to pandemics, work commitments and geographical isolation.

Patient’s and Practionner’s Experiences of a First Face-to-Face vs. Remote Orthodontic Consultation: A Randomized Controlled Trial

(1) Aim: The purpose of this study was to assess patients' and practitioners' reported experience measures (PREMs) following a first standard orthodontic consultation (face-to-face consultation) versus a first orthodontic teleconsultation (video-assisted remote orthodontic consultation).; (2) Materials and Methods: This study was designed as a randomized controlled trial in which 60 patients were randomly allocated to two groups. In the control group, patients received a first face-to-face consultation (n = 30) whereas, in the test group, patients received a first orthodontic teleconsultation (n = 30). Patients as well as the orthodontic practitioners completed questionnaires after the experience. (3) Results: From the patients' point of view, overall satisfaction was comparable between the control group and the test group (p = 0.23). Quality of communication with the clinician, understanding of the explanations provided and a sense of privacy were also comparable between the two groups. However, from the practitioners' perspective, overall satisfaction after the face-to-face consultation was significantly higher than after the first remote consultation (p < 0.01). (4) Conclusions: In the context of a first orthodontic consultation, teleorthodontics appears to be an interesting and complementary approach to a classical face-to-face appointment, but which should by no means become systematic.

Gov➔Value: How to combine reported quality experiences and patient-reported outcome measures. First results on vulvar cancer patients in an Italian Research Hospital.

Vulvar cancer (VC) accounts for <1% of cancers affecting the female gender. Clinical Pathways (CP) and Clinical Outcomes Monitoring are useful for providing high-quality care to these patients. However, it is essential to integrate them with the patient's perspective according to Value-Based Healthcare paradigms. Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are tools for assessing outcomes and experiences with health care from the patient's perspective. The aim of this paper is to collect and synthesize PROMs and main stakeholders' experience on the VC CP, according to a value-based approach. To select the most appropriate instrument, a review was conducted on the main databases and official websites of specific institutions and organizations. In the second phase, a 2-round Delphi survey was conducted to assess the Reported Experience Measures (REMs) tool. Questions were evaluated according to four criteria (general relevance, evidence-based, measurability, actionability) and included if strong agreement was reached. A Principal Component Analysis (PCA) was executed. Cronbach's alpha and McDonald's omega were computed. Fisher's exact test and Wilcoxon rank sum test were used to compare ratings between groups. Descriptive statistics were performed for both PROMs and REMs instruments. For PROMs assessment, EORTC QLQ-C30 questionnaire was selected and administered to 28 patients. Global Health Status/Quality of Life and Functional Scales Scores were high or very high, while symptoms scale reported low or medium scores. The final REMs consists of 22 questions for professionals and 16 for patients and caregivers. It was administered to 22 patients, 11 caregivers, 5 physicians, 2 nurses and 1 clinical senior manager. PCA identified 4 components. Scale reliability was acceptable (α = 0.75 95% CI: 0.61-0.85; ω = 0.69; 95% CI: 0.54, 0.82). A statistically significant difference between the patient/caregiver group and the professionals was found for items 8 (follow-up), 10 (perceived quality), 12 (safety), and 16 (climate) (p = 0.02; p = 0.03; p < 0.001; p < 0.001, respectively). PROMs could provide new ways of intercepting patients' needs and feedback, thus acting on them. The proposed REMs tool would allow to detect information not available elsewhere, which, through Audit and feedback strategies, could lead to enhancement of healthcare experience, according to a value-based approach.

Patients’ Reported Experience Measures with Primary Care Physicians in Bahrain

Background: Patients’ experience is divided into relational and functional, in which the former is related to the relationship in terms of the treatment, while the functional experience is related to healthcare facilities. Patients’ experience differs from patients’ satisfaction in which the former tests the interaction that patients have with the healthcare system in the ideal way, rather than patients’ expectation from the encounter. There are limited studies in the Middle East region regarding patients’ experience. Objective: The aim of the study was to establish a cornerstone for patients’ experience in primary healthcare centers in Bahrain. Methods: The study was a cross-sectional one where a validated questionnaire consisting of 10 questions was used. A sample of 50 patients was taken from each of the ten randomly selected healthcare centers. The patients were approached after ending their consultation at the general clinics. A total of 502 patients participated and their response was analyzed and included in the final results. Results: Patients’ experience in primary healthcare centers in Bahrain scored a mean of 42.4 out of 50, 84.8%. More than 70% of the responders answered the questions as very good and excellent. In terms of statistical significance, the timing of the consultation, nationality, and consultation fees yielded a p-value of 0.017, 0.011, and 0.005, respectively. On the other hand, results of patients’ experience scores regarding patients’ gender, doctors’ gender, age, education level, and marital status were statistically not significant. Conclusion: Bahrain’s mean score for patients’ experience in primary health centers was 84.8%. Keywords: Bahrain, Consultation, Middle East, Patients’ Satisfaction, Primary Health Care

Development and pilot of a burns-specific patient-reported experience measure

Patient –reported experience measures (PREMs) are a valuable tool in assessing patient’s subjective experiences within healthcare settings. They assist the evaluation and development of clinical services, and could be considered most useful when they assess elements of care pertinent to the specific health condition or clinical service. Currently there is no existing PREM to assess this in an NHS burns service. In the current project, a burns-specific PREM was created by identifying pre-existing condition specific PREMs in the literature and selecting key items pertinent to burn care for use in a brief questionnaire tool adapted in multiple versions to patient age and care setting. The measure was reviewed by the burns multidisciplinary team and piloted with patients attending the service. Twenty-seven participants completed the measure alongside an evaluation tool briefly assessing clarity, relevance and acceptability. While small, this pilot suggested that patients found the measure acceptable to complete and relevant to their care. It also yielded information not currently assessed by the service in any other format, appearing to promise utility for service development activities. Further work is needed to validate the tool and determine how its use could be implemented at a local and national level.

Development of a national audit tool for juvenile idiopathic arthritis: a BSPAR project funded by the Health Care Quality Improvement Partnership.

ObjectiveTimely access to holistic multidisciplinary care is the core principle underpinning management of juvenile idiopathic arthritis (JIA). Data collected in national clinical audit programmes fundamentally aim to improve health outcomes of disease, ensuring clinical care is equitable, safe and patient-centred. The aim of this study was to develop a tool for national audit of JIA in the UK.MethodsA staged and consultative methodology was used across a broad group of relevant stakeholders to develop a national audit tool, with reference to pre-existing standards of care for JIA. The tool comprises key service delivery quality measures assessed against two aspects of impact, namely disease-related outcome measures and patient/carer reported outcome and experience measures.ResultsEleven service-related quality measures were identified, including those that map to current standards for commissioning of JIA clinical services in the UK. The three-variable Juvenile Arthritis Disease Activity Score and presence/absence of sacro-iliitis in patients with enthesitis-related arthritis were identified as the primary disease-related outcome measures, with presence/absence of uveitis a secondary outcome. Novel patient/carer reported outcomes and patient/carer reported experience measures were developed and face validity confirmed by relevant patient/carer groups.ConclusionA tool for national audit of JIA has been developed with the aim of benchmarking current clinical practice and setting future standards and targets for improvement. Staged implementation of this national audit tool should facilitate investigation of variability in levels of care and drive quality improvement. This will require engagement from patients and carers, clinical teams and commissioners of JIA services.

A comparison of parent reported outcome with experience of services

Purpose – Routine outcome monitoring (ROM) is currently seen as a key driver for service improvement at individual, team and service level. The purpose this paper is to explore the relationships between a patient (parent) reported outcome measure (PROM), a practitioner reported outcome measure, and a patient (parent) reported experience measure (PREM). Design/methodology/approach – A cohort of 302 primary school-age children was recruited and followed for one year from consecutively accepted referrals to three teams within two English Child and Adolescent Mental Health Services (CAMHS). Parents completed the Strengths and Difficulties Questionnaire (a PROM) and practitioners completed the Clinician Global Assessment Scale at baseline, six and 12 months; parents completed the Experience of Services Questionnaire (a PREM) at six and 12 months. Findings – PROM and practitioner reported outcome measure data suggested poor clinical outcome in terms of symptoms, impact and levels of functioning but were accompanied by PREM evidence of high levels of satisfaction. There was an unexpectedly low correlation ( &lt; 0.2) between both measures of outcome and satisfaction. Originality/value – This paper fulfils a need to explore the relationships between different outcome measures to contribute to the understanding of ROM its validity.