Article type
Abstract
Background:
Patient reported outcome/experience measures (PROMs/PREMs) can be useful tools to evaluate the impact of implemented changes in health interventions on patients and carers.
Strong evidence supports the effectiveness of multicomponent hospital strategies to optimise hospital stay for older people after planned admission. However, the impact of an earlier discharge on patient outcomes, such as quality of life, over a longer period of recovery, is less well known. We conducted a systematic review to establish the impact of multicomponent interventions to enhance recovery after surgery on mid- to long-term patient outcomes. Here, we discuss the use of PROMs/PREMs to address this issue. Conclusions incorporate valuable insight from our patient and public involvement and engagement (PPIE) group.
Methods:
We sought primary research published until July 2023 evaluating interventions to reduce length of stay (LOS) for older (60yrs or above) hospital inpatients admitted for planned surgery and including at least one PROM/PREM. The number, type and frequency of PROM/PREM use in RCTs or UK-based comparative studies was described. We met with a PPIE group four times during the project.
Results:
Of 22,791 unique records identified, 1133 were screened at full text. Only 49 RCTs or UK-based comparative trials were included. Generic PROMs such as SF-36 were regularly used, rather than condition-specific choices. The inclusion of PROMs/PREMs often lacked a strong rationale or commitment from authors. PROMs were often only used at single time-points, failed to address key issues or omitted the views of carers. PROMs were rarely used to evaluate longer term recovery of the patient, or impact on carers/relatives or wider community services. PREMs were rarely reported, usually taking the form of an ad hoc survey or questionnaire. Our PPIE group reflected that the use of PROMs/PREMs failed to adequately capture the voice of patients and carers.
Conclusions:
The assessment of patient outcomes in trials evaluating interventions to reduce LOS in older adults is severely limited. Thus, we are currently unable to assess the local impact of internationally developed initiatives to achieve early discharge from hospital. Improvement and standardisation of approaches to the use of PROMs/PREMs is required.
Patient reported outcome/experience measures (PROMs/PREMs) can be useful tools to evaluate the impact of implemented changes in health interventions on patients and carers.
Strong evidence supports the effectiveness of multicomponent hospital strategies to optimise hospital stay for older people after planned admission. However, the impact of an earlier discharge on patient outcomes, such as quality of life, over a longer period of recovery, is less well known. We conducted a systematic review to establish the impact of multicomponent interventions to enhance recovery after surgery on mid- to long-term patient outcomes. Here, we discuss the use of PROMs/PREMs to address this issue. Conclusions incorporate valuable insight from our patient and public involvement and engagement (PPIE) group.
Methods:
We sought primary research published until July 2023 evaluating interventions to reduce length of stay (LOS) for older (60yrs or above) hospital inpatients admitted for planned surgery and including at least one PROM/PREM. The number, type and frequency of PROM/PREM use in RCTs or UK-based comparative studies was described. We met with a PPIE group four times during the project.
Results:
Of 22,791 unique records identified, 1133 were screened at full text. Only 49 RCTs or UK-based comparative trials were included. Generic PROMs such as SF-36 were regularly used, rather than condition-specific choices. The inclusion of PROMs/PREMs often lacked a strong rationale or commitment from authors. PROMs were often only used at single time-points, failed to address key issues or omitted the views of carers. PROMs were rarely used to evaluate longer term recovery of the patient, or impact on carers/relatives or wider community services. PREMs were rarely reported, usually taking the form of an ad hoc survey or questionnaire. Our PPIE group reflected that the use of PROMs/PREMs failed to adequately capture the voice of patients and carers.
Conclusions:
The assessment of patient outcomes in trials evaluating interventions to reduce LOS in older adults is severely limited. Thus, we are currently unable to assess the local impact of internationally developed initiatives to achieve early discharge from hospital. Improvement and standardisation of approaches to the use of PROMs/PREMs is required.