Patient-reported outcome measures in value-based healthcare: A multiple methods study to assess patient-centredness

Patient Education and Counseling, vol. 125, pp. 108243

Abstract

Value-based healthcare (VBHC) involves the use of standardised outcome measures, including patient-reported outcome measures (PROMs). This study aimed to assess to what extent discussion of PROMs is associated with patient- and person-centredness. This study used a separate sample pre-/post-test design and multiple methods (observations, questionnaires, and interviews) in a VBHC care pathway for patients with a vestibular schwannoma, to assess to what extent the implementation of PROMs is associated with a difference in patient- and person-centredness. A total of 139 patients with a vestibular schwannoma and their four treating physicians were included in the study. No significant differences were found in observed patient-centredness (Mpre=6.71±2.42 vs. Mpost=6.93±2.01; P=0.60) or patient-reported patient-centredness (Mpre=1.73 vs. Mpost=1.68; P=0.63) and person-centredness after PROM implementation (Mpre=11.81 vs. Mpost=13.42; P=0.34). We observed more discussion of patient-reported outcomes. However, a majority of patients did not expect PRO discussion in consultations. The implementation of standardised PROMs in a VBHC care pathway was associated with more discussion on patient-reported outcomes in clinical consultations. Overall, the implementation of PROMs was not observed or perceived as leading to more patient-centred consultations. Physicians should assess whether the discussion of PROMs add value collaboratively with patients.

Authors 7

1. Martha Kidanemariam corresponding Aachen Medical Decision Making Department of Biomedical Data Sciences Medical Decision Making Department of Biomedical Data Sciences

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: m.kidanemariam@lumc.nl

   Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands

2. Olaf M. Neve Aachen Department of Otorhinolaryngology and Head & Neck Surgery Department of Otorhinolaryngology and Head and Neck Surgery

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands

   Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, the Netherlands

3. Isabelle van den Heuvel

   Erasmus University Rotterdam

   Affiliation as printed

   Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands

   Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands

4. Sana Douz Aachen Medical Decision Making Department of Biomedical Data Sciences Medical Decision Making Department of Biomedical Data Sciences

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands

   Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands

5. Erik Frans Hensen Aachen Department of Otorhinolaryngology and Head & Neck Surgery Department of Otorhinolaryngology and Head and Neck Surgery

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands

   Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, the Netherlands

6. Anne Margarethe Stiggelbout Aachen Medical Decision Making Department of Biomedical Data Sciences

   Leiden University · Leiden University Medical Center · Erasmus University Rotterdam

   Affiliation as printed

   Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands

   Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands

   Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands

7. Arwen H. Pieterse Aachen Medical Decision Making Department of Biomedical Data Sciences Medical Decision Making Department of Biomedical Data Sciences

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands

   Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands