Current status of PROMs in guidelines on osteoarthritis: a review

Tags: Oral
van Dulmen S1, Verkerk E1, van der Wees P1, Meerhoff G1
1Radboudumc

Background: Patient Reported Outcome Measures (PROMs) are questionnaires that capture patients’ views on their health status, and are deemed important for improving quality of care. Individual PROMs data can be used for screening, goal setting, monitoring and evaluation. Clinical practice guidelines are meant to facilitate delivery of good quality care, and should therefore uniformly support the use of PROMs. Little is known about the current recommended use of PROMs for individual clinical practice in guidelines for different disciplines.

Objectives: The goal of our study was to identify the frequency, type and recommended use of PROMs in guidelines with recommendations for diagnosis and treatment of osteoarthritis.

Methods: We searched PubMed, national and international guideline databases, and websites of organisations or caregiver associations of disciplines that provide care for patients with osteoarthritis.

Results: We included 42 guidelines containing 32 PROMs. The majority of the guidelines did not recommend PROMs. Most recommended PROMs were the visual-analog scale (VAS) for measuring pain, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee injury and Osteoarthritis Outcome Score (KOOS) in hip and/or knee osteoarthritis. Guidelines provided scarce information about how PROMs should be used in clinical care and there is little overlap between different types of healthcare providers. Guidelines for physical therapy include 50% of the PROMs.

Conclusions: PROMs are lacking in most international guidelines on osteoarthritis. When PROMs are recommended, there is a wide variation within and between countries and professionals. There is little guidance for clinicians for using PROMs in clinical practice. For meaningful use in clinical practice guidelines should include information how PROMs should be used (e.g. for diagnostic-treatment purposes) and how scores should be interpreted.

On behalf of the G-I-N Allied health working group