• Fitness & Health
• Sport & Exercise Science
• Physical Education
• Strength & Conditioning
• Sports Medicine
• Sport Management
• Dance

Why are Patient-Reported Outcome Measures (PROMs) important?

This is an excerpt from Examination of Musculoskeletal Injuries 5th Edition With HKPropel Access by Sandra J. Shultz & Tamara C. Valovich McLeod.

Patient-Reported Outcome Measures

While the subjective history allows you to collect information about symptoms, patient-reported outcome measures (PROMs) allow you to collect additional information about the patient’s health status. This information supplements the physical examination components and aids in treatment planning and determining the intervention effectiveness. PROMs are administered as self-report surveys or questionnaires and are used to obtain the patient’s perspective regarding their symptoms, impairments, functional status, and health-related quality of life. Health-related quality of life considers the “physical, psychological, and social domains of health, seen as distinct areas that are influenced by a person’s experiences, beliefs, expectations, and perceptions.”1 Many PROMs aim to evaluate health-related quality of life through general domains, such as physical functioning, psychological functioning, cognitive functioning, social well-being, and disability.

Including PROMs in the examination process allows clinicians to obtain information directly from the patient more objectively compared to the typical history portion of an assessment, which allows patient-specific concerns to be included into the care plan and tracked over the course of recovery. Patient-oriented outcomes complement clinician-based outcomes in ensuring evaluations include all domains of contemporary disablement models. Disablement models are frameworks for clinical practice, research, and health care policy that consider that the patient’s experience is the result of several interrelated factors. Most health care disciplines have adopted the World Health Organization International Classification of Functioning, Disability, and Health (ICF) model (figure 10.2).

The ICF model also considers environmental and personal factors that can influence health status. Environmental factors are often extrinsic and may include the physical and social environment as well as social support and relationships, available services, and health care policies. Personal factors are more intrinsic, such as age, prior medical history, life experiences, and education, among others. Both environmental and personal factors can include other social determinants of health: the conditions in which people are born, grow, live, work, and age. This includes employment, social environment, public safety, housing, education, race, health services, transportation, environment, income, and wealth.2 Using generic and specific PROMs can assist clinicians in assessing all disablement model domains to provide whole-person health care.

Generic vs Specific vs Single-item PROMs
Many PROMs are available, and each clinician needs to assess patient-specific factors (e.g., type of injury, illness, or condition, patient’s age, patient’s activity level) and administrative factors (e.g., time available to administer, electronic versus paper) before choosing which to administer. Furthermore, clinicians should understand the criteria for selecting PROMs (table 10.1) and whether a PROM is appropriate for a specific patient. At the most basic level, PROMs are categorized into three categories: generic, specific, and single item.3

Generic, or general, PROMs are global assessments that may evaluate a broad range of domains often associated with health-related quality of life. These PROMs typically contain subscales that focus on physical, psychological, social, or emotional constructs for how the condition impacts overall health status. Since generic PROMs capture these global domains, they can be used to assess patients across a wide range of illnesses and injuries. However, it may be more difficult to assess changes in scores throughout treatment due to the lack of specificity in the included items. Some patients may find the questions irrelevant to their specific situation, especially if they are a high-functioning athlete and the PROM was intended for a general patient population.



More Excerpts From Examination of Musculoskeletal Injuries 5th Edition With HKPropel Access

---