Breaking barriers, deepening dialogue The implementation of patient-reported outcome measures in daily clinical care

This thesis focuses on optimizing the implementation of Patient Reported Outcome Measures (PROMs) in daily clinical care to enhance patient-clinician discussions about outcomes that are important to patients and to stimulate the use of PROMs within shared decision-making (SDM).
Using PROMs in daily clinical care involves several steps, described in the ‘PROM journey’: 1) selecting PROMs, 2) completing PROMs, 3) presenting PROM results, and 4) discussing PROM results. Despite the growing use, the implementation of PROMs remains challenging. This thesis aimed to address a selection of implementation barriers across the PROM journey.
First, the initiation and working method of the Amsterdam PROM Expertise Centre (PEC) are described. PEC is a multidisciplinary team that developed a PROM policy and implementation pathway to support healthcare teams in integrating PROMs into daily clinical care. Subsequently, barriers across the PROM journey were addressed:
1. Selecting PROMs: translating and validating Patient Reported Outcomes Measurement Information System (PROMIS®) measures assessing sexual functioning and satisfaction for Dutch individuals;
2. Completing PROMs: gaining insight into patient education initiatives described in the literature;
3. Presenting PROMs: gaining insight into patients’ needs and preferences regarding the presentation of PROM results;
4. Discussing PROMs: gaining insight into how clinicians discuss PROM results in real-life and illustrating how PROMs can be integrated into SDM through the PROMxSDM framework.
Overall, this thesis contributes to the optimization of PROM implementation and use in daily clinical care. Continued collaboration between patients, clinicians, researchers, implementation-, and application specialists is essential for further optimization.