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Meerhoff G1,2, van Dulmen S1, Cruijsberg J1, Nijhuis-van der Sanden R1, van der Wees P1
1Radboud University Medical Center, IQ Healthcare, Nijmegen, Netherlands, 2Royal Dutch Society for Physical Therapy (KNGF), Quality, Amersfoort, Netherlands
Background: Patient reported outcome measures (PROMs) can assist in improving patient centeredness, one of the domains of the healthcare quality definition according to the Institute Of Medicine. Although PROMs are included in clinical practice guidelines research has shown they are not yet widely implemented in clinical practice. In a national quality program of the Royal Dutch Society for Physiotherapy (KNGF), a new system is being developed in which the use of PROMs is a key element. Within this program the PROMs are extracted from the Electronic Health Record (EHR)-systems from physiotherapists and collected in the national registry. For this program an extensive implementation strategy is developed that - amongst other objectives - focused on increasing the use of PROMs. Although the implementation strategy increased the use of PROMs, higher implementation percentages were expected. Due to the suboptimal implementation it remains unclear if PROMs can fulfil their potential role in physiotherapy practice.
Purpose: To inform the further development of implementation strategies that stimulate PROM use, it is important to identify factors that may facilitate PROM use.
This study aims to identify factors that influence the use of PROMs in Dutch primary care physiotherapy practice.
Methods: In this prospective observational cohort study physiotherapists (n=444) completed a self-assessment questionnaire and uploaded data from their electronic health record (EHR) systems to the national registry. Multilevel logistic and linear regression models were used to identify factors for self-reported PROM use and PROM use registered in EHR-systems, derived from the self-assessment questionnaire, and from data in the national registry, respectively. Factors from both models were categorized as: physiotherapists' demographic characteristics, their practice characteristics, their knowledge and attitudes, and contextual factors related to PROM use.
In identifying the factors the consistency between both models was verified.
Results: Self-reported PROM use was associated with the practice characteristic EHR-systems supporting PROM use (OR: 2.04; 95% CI: 1.10-3.79), more knowledge (OR:7.07;95%CI:3.14-15.96), and positive attitudes for using PROMs (OR: 2.10; 95% CI: 1.10-3.99). PROM use registered in EHR-systems was associated with the practice characteristic EHR-systems supporting PROM use (B: 22.61; 95% CI: 8.55-36.67) and more knowledge (B: 13.78; 95% CI: 4.99-22.56).
Conclusion(s): Factors increasing PROM use are EHR-systems supporting PROM use, and more knowledge related to PROMs and their use.
Implications: Based on the findings of this study for future implementation activities to be most successful it is important to invest in the knowledge of physiotherapists on how to use PROMs and invest in the technological support, given by the EHR-systems in the use of PROMs in clinical practice.
Keywords: Patient Reported Outcome Measures, Quality improvement, Professionalism education
Funding acknowledgements: KNGF supported this study but had no role in the data collection, analysis, interpretation and writing of the report.
Purpose: To inform the further development of implementation strategies that stimulate PROM use, it is important to identify factors that may facilitate PROM use.
This study aims to identify factors that influence the use of PROMs in Dutch primary care physiotherapy practice.
Methods: In this prospective observational cohort study physiotherapists (n=444) completed a self-assessment questionnaire and uploaded data from their electronic health record (EHR) systems to the national registry. Multilevel logistic and linear regression models were used to identify factors for self-reported PROM use and PROM use registered in EHR-systems, derived from the self-assessment questionnaire, and from data in the national registry, respectively. Factors from both models were categorized as: physiotherapists' demographic characteristics, their practice characteristics, their knowledge and attitudes, and contextual factors related to PROM use.
In identifying the factors the consistency between both models was verified.
Results: Self-reported PROM use was associated with the practice characteristic EHR-systems supporting PROM use (OR: 2.04; 95% CI: 1.10-3.79), more knowledge (OR:7.07;95%CI:3.14-15.96), and positive attitudes for using PROMs (OR: 2.10; 95% CI: 1.10-3.99). PROM use registered in EHR-systems was associated with the practice characteristic EHR-systems supporting PROM use (B: 22.61; 95% CI: 8.55-36.67) and more knowledge (B: 13.78; 95% CI: 4.99-22.56).
Conclusion(s): Factors increasing PROM use are EHR-systems supporting PROM use, and more knowledge related to PROMs and their use.
Implications: Based on the findings of this study for future implementation activities to be most successful it is important to invest in the knowledge of physiotherapists on how to use PROMs and invest in the technological support, given by the EHR-systems in the use of PROMs in clinical practice.
Keywords: Patient Reported Outcome Measures, Quality improvement, Professionalism education
Funding acknowledgements: KNGF supported this study but had no role in the data collection, analysis, interpretation and writing of the report.
Topic: Outcome measurement; Professional issues
Ethics approval required: Yes
Institution: Radboudumc
Ethics committee: Medical Ethical Committee of Radboud university medical center
Ethics number: #2014/260
All authors, affiliations and abstracts have been published as submitted.
