scholarly journals A novel patient-reported outcome monitoring with clinical feedback system in bariatric surgery care: study protocol, design and plan for evaluation

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e037685
Author(s):  
Pål André Hegland ◽  
Anny Aasprang ◽  
Ronette L Kolotkin ◽  
Christian Moltu ◽  
Grethe S Tell ◽  
...  
Keyword(s):  
Mental Health ◽  
Bariatric Surgery ◽  
Data Protection ◽  
Healthcare Professionals ◽  
Feedback System ◽  
Patient Reported Outcome ◽  
Outpatient Clinics ◽  
Outcome Monitoring ◽  
Patient Reported ◽  
Clinical Feedback

BackgroundConsultations before and after bariatric surgery should include structured assessments of patients’ health-related quality of life (HRQOL) and mental health. One way to conduct this assessment is to implement patient-reported outcome monitoring with a clinical feedback system (PRO/CFS).AimWe will explore patients’ and healthcare professionals’ experiences when a PRO/CFS is an integrated part of bariatric surgery care.Methods and analysesThis is a design paper in which a PRO/CFS will be implemented in two bariatric outpatient clinics. All patients who have an appointment with a healthcare professional prior to, and 3 and 12 months after surgery, will be asked to complete six digital questionnaires measuring HRQOL, mental health, bowel symptoms and eating self-efficacy prior to each consultation. A digital summary report generated from the patient’s responses will form the basis for the clinical consultation. A team of patient representatives, healthcare professionals and researchers will be involved in all phases of designing the PRO/CFS to ensure its relevance for clinical consultations. The patients’ experiences will be explored with a generic 12-item questionnaire, developed for use in outpatient clinics, prior to and 12 months after bariatric surgery. We will conduct focus-group interviews with patients and healthcare professionals to explore their experiences when PRO/CFS is integrated into the consultations.Ethics and disseminationWritten informed consent will be obtained for all participants in the study. The project is approved by the Norwegian Centre for Research Data, Department of Data Protection Services (ref. no. 282738). The project has also undergone Data Protection Impact Assessments, both at Førde Hospital Trust and at St. Olav Hospital (registration no. 2016/3912). Data from the qualitative and quantitative studies will be kept in de-identified form in a secured research database, and the findings will be published in international peer-reviewed journals and presented at scientific conferences.

scholarly journals Do CAMHS collect less PROM data from certain sociodemographic groups?

2020 ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measures ◽  
Treatment Efficacy ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Outcome Monitoring ◽  
Patient Reported ◽  
Low Rate

Patient-reported outcome measures (PROMs) are routinely used to inform clinicians and policymakers on clinical need and treatment efficacy. Yet despite their great value and utility, it seems that there is a low rate of outcome monitoring in Child and Adolescent Mental Health Services (CAMHS).

scholarly journals Information is a key prerequisite for perceived relevance of patient reported outcome data (PRO data): A multicenter questionnaire study

2019 ◽  
Vol 9 (6) ◽  
pp. 107
Author(s):  
Malene Kildemand ◽  
Hanne Merete Lindegaard ◽  
Mette Juel Rothmann ◽  
Birgitte Nørgaard
Keyword(s):  
Patient Involvement ◽  
Healthcare Professionals ◽  
Clinical Care ◽  
Patient Reported Outcome ◽  
Outcome Data ◽  
Outpatient Clinics ◽  
Routine Clinical Care ◽  
Patient Reported ◽  
Perceived Relevance ◽  
Danish Hospital

Objective: The aim of this study was to investigate the relevance of patient reported outcome data (PRO data) as assessed by arthritis patients in a Danish hospital setting.Methods: The study was conducted as a multicenter questionnaire survey comprising patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis at three rheumatology outpatient clinics. Respondents with experience of reporting PRO data were recruited. The recruitment took place in March 2017.Results: A total of 98 respondents were included. We found significant correlation between respondents’ level of information about PRO data and the perceived relevance of PRO data questions. Remarkably, a third of the respondents stated that PRO data prepared neither themselves nor the healthcare professionals for the consultation, while 40% found that their PRO data responses were not used during consultations with healthcare professionals.Conclusions: The respondents’ assessment of the relevance of PRO data depended on the information offered to them. In recognition of its potential as a tool for patient involvement, the use of PRO data should be formally integrated in routine clinical care.

Clinical dilemmas of routine outcome monitoring and clinical feedback: a qualitative study of patient experiences

2020 ◽  
Author(s):  
Stig Magne Solstad ◽  
Gøril Kleiven Solberg ◽  
Louis George Castonguay ◽  
Christian Moltu
Keyword(s):  
Mental Health ◽  
Clinical Skill ◽  
Routine Outcome Monitoring ◽  
Future Research ◽  
Successful Implementation ◽  
Basic Training ◽  
Feedback Systems ◽  
Clinical Encounters ◽  
Outcome Monitoring ◽  
Clinical Feedback

Purpose: Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming prevalent in mental health services. The field faces several challenges to successful implementation. The purpose of this study is to gain a better understanding of these challenges by exploring the patient perspective. Method: We report the findings from a qualitative, video assisted interview study of 12 patients from a Norwegian mental health outpatient clinic using ROM/CFS. Results: Our analysis resulted in three pairs of opposing experiences with using ROM/CFS: 1) Explicit vs. implicit use of CFS information, 2) CFS directing focus towards- vs. directing focus away from therapeutic topics and 3) Giving vs. receiving feedback. None of these were intrinsically helpful or hindering. Participants had vastly differing preferences for how to use ROM/CFS in clinical encounters, but all needed the information to be used in a meaningful way by their therapists. If not, ROM/CFS was at risk of becoming meaningless and hindering for therapy. Conclusion: These findings confirm and provide further nuance to previous research. We propose to consider ROM/CFS a clinical skill that should be a part of basic training for therapists. How to use and implement ROM/CFS skillfully should also be the focus of future research.

scholarly journals How to implement routine electronic patient‐reported outcome monitoring in oncology rehabilitation

2020 ◽  
Author(s):  
Lisa M. Wintner ◽  
Monika Sztankay ◽  
David Riedl ◽  
Gerhard Rumpold ◽  
Alain Nickels ◽  
...  
Keyword(s):  
Patient Reported Outcome ◽  
Outcome Monitoring ◽  
Patient Reported

scholarly journals Assessing the Attitudes, Awareness, and Behavioral Alterations of Patients Awaiting Total Hip Arthroplasty During the COVID-19 Crisis

2020 ◽  
Vol 11 ◽  
pp. 215145932096937
Author(s):  
Stephen Fahy ◽  
Joss Moore ◽  
Michael Kelly ◽  
Shane Irwin ◽  
Paddy Kenny
Keyword(s):  
Mental Health ◽  
Short Form ◽  
Hip Osteoarthritis ◽  
Surgical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Physical And Mental Health ◽  
Patient Reported ◽  
Hip Function

Background: COVID-19 has placed a huge burden on healthcare systems which has led to widespread cancellation elective surgical care. Ireland is recovering from the first wave of COVID-19 and as such the expeditious return of elective surgical care is important. This is the first study to examine the attitudes of patients to undergoing total joint arthroplasty during the COVID-19 crisis. Methods: A prospective qualitative study was undertaken in our institution during the week 13/05/2020-20/05/2020. 65 patients completed a questionnaire assessing attitudes, awareness, and behavioral changes associated with COVID-19, a Charlson Comorbidity Index, modified-Harris Hip Score, and a Short Form-12 score. Results: 86% of patients felt that they were at little to no risk of COVID-19 infection. The majority of patients were happy to proceed with surgery at the current level of COVID-19 related threat (86%). Patients with higher mHHS were more likely to postpone their operation than those with lower mHHS scores. Our cohort had low patient reported outcome measures in both mHHS and SF-12, indicating the significant burden of hip osteoarthritis on both physical and mental health. Conclusion: Patients reported a significant disease-related impairment of physical function and subsequent deterioration in mental health as a result of hip osteoarthritis. Patients with worse hip function, as measured by the mHHS are more willing to proceed with surgery than those with superior hip function. This offers a potential mechanism by which to triage patients once elective surgical pathways reopen in the coming months.

scholarly journals Preoperative mental health status may not be predictive of improvements in patient-reported outcomes following an anterior cervical discectomy and fusion

2017 ◽  
Vol 26 (2) ◽  
pp. 177-182 ◽  
Author(s):  
Benjamin C. Mayo ◽  
Dustin H. Massel ◽  
Daniel D. Bohl ◽  
Ankur S. Narain ◽  
Fady Y. Hijji ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Status ◽  
Patient Reported Outcomes ◽  
Patient Reported Outcome ◽  
Mental Health Status ◽  
Anterior Cervical Discectomy ◽  
Arm Pain ◽  
Vas Score ◽  
Patient Reported ◽  
Postoperative Time

OBJECTIVE Prior studies have correlated preoperative depression and poor mental health status with inferior patient-reported outcomes following lumbar spinal procedures. However, literature regarding the effect of mental health on outcomes following cervical spinal surgery is limited. As such, the purpose of this study is to test for the association of preoperative SF-12 Mental Component Summary (MCS) scores with improvements in Neck Disability Index (NDI), SF-12 Physical Component Summary (PCS), and neck and arm pain following anterior cervical discectomy and fusion (ACDF). METHODS A prospectively maintained surgical database of patients who underwent a primary 1- or 2-level ACDF during 2014–2015 was reviewed. Patients were excluded if they did not have complete patient-reported outcome data for the preoperative or 6-week, 12-week, or 6-month postoperative visits. At baseline, preoperative SF-12 MCS score was assessed for association with preoperative NDI, neck visual analog scale (VAS) score, arm VAS score, and SF-12 PCS score. The preoperative MCS score was then tested for association with changes in NDI, neck VAS, arm VAS, and SF-12 PCS scores from the preoperative visit to postoperative visits. These tests were conducted using multivariate regression controlling for baseline characteristics as well as for the preoperative score for the patient-reported outcome being assessed. RESULTS A total of 52 patients were included in the analysis. At baseline, a higher preoperative MCS score was negatively associated with a lower preoperative NDI (coefficient: −0.74, p < 0.001) and preoperative arm VAS score (−0.06, p = 0.026), but not preoperative neck VAS score (−0.03, p = 0.325) or SF-12 PCS score (0.04, p = 0.664). Additionally, there was no association between preoperative MCS score and improvement in NDI, neck VAS, arm VAS, or SF-12 PCS score at any of the postoperative time points (6 weeks, 12 weeks, and 6 months, p > 0.05 for each). The percentage of patients achieving a minimum clinically important difference at 6 months did not differ between the bottom and top MCS score halves (p > 0.05 for each). CONCLUSIONS The results of this study suggest that better preoperative mental health status is associated with lower perceived preoperative disability but is not associated with severity of preoperative neck or arm pain. In contrast to other studies, the present study was unable to demonstrate that preoperative mental health is predictive of improvement in patient-reported outcomes at any postoperative time point following an ACDF.

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