'Unspoken Questions': A Qualitative Study of Rheumatologists’ Perspectives on the Clinical Implementation of Patient-reported Outcome Measures
| Autor: | John B. Wong, Amy M LeClair, Shanthini Kasturi, Lisa A. Mandl, Timothy E. McAlindon |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Immunology Psychological intervention MEDLINE Physician education Article Culture change 03 medical and health sciences 0302 clinical medicine Rheumatology medicine Added value Humans Immunology and Allergy Patient Reported Outcome Measures 030212 general & internal medicine Qualitative Research 030203 arthritis & rheumatology Physician-Patient Relations business.industry Outcome measures female genital diseases and pregnancy complications Family medicine Female Patient-reported outcome Patient Participation Rheumatologists business Qualitative research |
| Zdroj: | J Rheumatol |
| ISSN: | 1499-2752 0315-162X |
| DOI: | 10.3899/jrheum.200232 |
| Popis: | ObjectiveTo identify rheumatologists’ views on perceived barriers and facilitators to the clinical implementation of patient-reported outcome measures (PROM).MethodsSemistructured interviews were conducted with academically affiliated clinical rheumatologists. Interviews were audio-recorded and transcribed. Deidentified transcripts were independently coded and analyzed for themes.ResultsFifteen attending rheumatologists, 8 women (53%) and 7 men (47%) with a mean of 17.3 years in practice (range 5–43) at 2 urban academic medical centers, participated in interviews. Rheumatologists identified several barriers to integrating PROM in clinical care, highlighting physician buy-in and culture change as significant challenges beyond logistical considerations. They further underscored the lack of effective interventions and resources for addressing the domains of most interest to patients. Physicians also recognized significant benefits of PROM in clinical care, including contributing to the clinical impression by providing the patient perspective, and promoting agenda setting by uncovering “unspoken questions.” They additionally noted that PROM could support treatment planning, build patient-physician relationships, and facilitate patient engagement. Participants suggested that technology, physician education, and team-based care could facilitate the effective implementation of PROM.ConclusionRheumatologists identified multiple mechanisms through which PROM could augment clinical care, but also noted several obstacles to implementation, questioning the added value of PROM and the limited availability of interventions to improve patient-centered outcomes. Programs seeking to successfully integrate PROM to enhance patient-centered care and meet quality benchmarks should prioritize physician buy-in and training, and provide resources to address the outcomes that are measured. |
| Databáze: | OpenAIRE |
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