This article is more than 5 years old. Information may no longer be current.

PCPs not using patient-reported outcome measures to fullest potential

Patient-reported outcome measures could be useful, but primary care physicians are not using the information gathered from them to improve patient care, according to findings recently published in Quality of Life Research.

“A key voice is missing in our ability to understand the role of [patient-reported outcome measures] in primary care — that of the patient,” Tasneem L. Talib, PhD, of the Regenstrief Institute, Indianapolis, and colleagues wrote.

To assess patients’ thoughts on patient-reported outcome measures, researchers conducted one-on-one interviews with 23 patients aged 24 to 77 years with sleep, pain, anxiety, depression, and/or low energy/fatigue symptoms to ascertain the patients’ feelings about the implementation, use, and visual display of PROMIS, a tool that patients use to score clinicians on symptom outcomes.

According to researchers, interviewees felt patient-reported outcome measures:

• encourage communication about symptoms;
• cause clinical actions;
• use visual displays of symptom scores to increase understanding;
• vary in implementation; and
• need to be valued, prioritized, and used.

Talib and colleagues acknowledged there are barriers that can hinder efforts to obtain patient-reported outcome measures.

“Providers in primary care contend with short clinic visits, minimal training in symptom-based care, demands associated with making sense of comorbid symptoms in the context of multiple, often chronic medical conditions, and the expectation of addressing numerous preventative medicine and disease-based guidelines,” Talib and colleagues wrote.

They provided suggestions to ensure patient-reported outcome measures are not neglected.

• Acknowledge patients’ willingness to complete the measures and ask patients if they need help doing so.
• Encourage patients to report symptoms even if they not directly evaluated by patient-reported outcomes.
• Address symptom-specific concerns at initial and follow-up visits.
• Develop self-management strategies enhanced by nurse care, to support patient involvement, promote maintenance of behaviors, and reduce costs.

In a press release, study co-author Kurt Kroenke, MD, also of the Regenstrief Institute, suggested other potential ways for most clinicians to utilize patient-reported outcome measures.

“Patient reported symptoms are not routinely put into a patient's electronic medical record, and most EMR systems are not designed to include symptoms,” Kroenke said in a press release. “The health care system spends a lot of money on lab and imaging test results, which we put into the patient's EMR; shouldn't we be valuing patient-reported symptoms enough to put them into that same record?”

Kroenke also proposed PCPs involve nurses and other non-physicians in patient visits and utilize telecare, online and other self-management tools to ensure enough time to discuss patient-reported outcome measures. – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.