Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability

Brusco, Natasha; Atkinson, V; Woods, Jeffrey; Myles, PS; Hodge, Anita; Jones, C; Lloyd, Damien; Rovtar, V; Clifford, AM; Morris, Meg

doi:10.26181/21391782.v1

Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability

journal contribution

posted on 2022-10-25, 04:15 authored by Natasha BruscoNatasha Brusco, V Atkinson, Jeffrey Woods, PS Myles, Anita HodgeAnita Hodge, C Jones, Damien Lloyd, V Rovtar, AM Clifford, Meg MorrisMeg Morris

Background: Patient reported outcome measures (PROMs) engage patients in co-evaluation of their health and wellbeing outcomes. This study aimed to determine the feasibility, response rate, degree of recovery and patient acceptability of a PROM survey for elective surgery. Methods: We sampled patients with a broad range of elective surgeries from four major Australian hospitals to evaluate (1) feasibility of the technology used to implement the PROMs across geographically dispersed sites, (2) response rates for automated short message service (SMS) versus email survey delivery formats, (3) the degree of recovery at one and four weeks post-surgery as measured by the Quality of Recovery 15 Item PROM (QoR-15), and (4) patient acceptability of PROMS based on survey and focus group results. Feasibility and acceptability recommendations were then co-designed with stakeholders, based on the data. Results: Over three months there were 5985 surveys responses from 20,052 surveys (30% response rate). Feasibility testing revealed minor and infrequent technical difficulties in automated email and SMS administration of PROMs prior to surgery. The response rate for the QoR-15 was 34.8% (n = 3108/8919) for SMS and 25.8% (n = 2877/11,133) for email. Mean QoR-15 scores were 122.1 (SD 25.2; n = 1021); 113.1 (SD 27.7; n = 1906) and 123.4 (SD 26.84; n = 1051) for pre-surgery and one and four weeks post-surgery, respectively. One week after surgery, 825 of the 1906 responses (43%) exceeded 122.6 (pre-surgery average), and at four weeks post-surgery, 676 of the 1051 responses (64%) exceeded 122.6 (pre-surgery average). The PROM survey was highly acceptable with 76% (n = 2830/3739) of patients rating 8/10 or above for acceptability. Fourteen patient driven recommendations were then co-developed. Conclusion: Administering PROMS electronically for elective surgery hospital patients was feasible, acceptable and discriminated changes in surgical recovery over time. Patient co-design and involvement provided innovative and practical solutions to implementation and new recommendations for implementation.

Funding

This study was funded by Healthscope Australia.

History

Publication Date

2022-07-07

Journal

Journal of Patient-Reported Outcomes

Volume

6

Article Number

73

Pagination

17p.

Publisher

Springer Nature

ISSN

2509-8020

Rights Statement

© The Author(s) 2022 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.