APEx Seminar

Integrating Patient Reported Outcome Measures (PROMs) into routine primary care for patients with multimorbidity: A feasibility study

Dr Ian Porter

Patient Reported Outcome Measures (PROMS) are questionnaires completed by patients to rate their own health. Currently PROMs are used to measure health gain for patients undergoing specific surgical procedures (for example hip and knee replacements) but there is little evidence for their use in general practice, where they are not routinely used. PROMs have the potential to improve the quality of healthcare people receive at their GP surgery, and promote a more patient-orientated service. For patients with multiple conditions they could be helpful for prioritising their health issues, and aligning the views of patients and professionals. However, research is needed to test the feasibility of this.

The aim of this study is to develop and test ways for the efficient collection and feedback of PROMs in general practice for people with multiple health conditions. In order to do this we have asked patients with different combinations of selected conditions (asthma, chronic obstructive pulmonary disease, diabetes, heart failure, depression, osteoarthritis of the hip and/or knee) to complete PROMs immediately ahead of existing annual reviews, so as to fit into existing delivery of care and minimise disruption to participating patients and practitioners.

Feedback is at the heart of this study: a) PROMs results are fed back in real time to inform the annual review, to both the patient and the practitioner conducting the review; b) we also collect feedback from patients and practitioners about whether our method for collecting and feeding back PROMs is valuable and appropriate, and how it can be improved. This will provide us with important information, such as identifying barriers and facilitators, understanding of better ways to administer and feedback PROMs, ultimately informing a more patient-focused general practice.

Models of Care for patients with multimorbidity in the UK

Dr Charlotte Bramwell

The management of patients with multimorbidity is an increasingly common problem faced by health systems worldwide. The prevalence of multimorbidity is substantial and it presents in the majority of GP consultations in the UK, carrying an inevitable healthcare cost burden. Chronic illness care has traditionally been disease orientated, but this is not necessarily an effective model for the multimorbid patient. There is limited information regarding the effectiveness of current models of care focused on this patient group. Investigation and evaluation of such initiatives is paramount for improving care for this substantial patient group.