Implementing patient reported outcomes in diabetes routine clinical care

If we really want to know what the impact of clinical care including treatment is on the patient then the most reliable way of finding out is to ask the patient. Patient reported outcome measures (PROMs)are increasingly being  used to gather this information. Whether the implementation of the PROM is for research, clinical care or community and population surveys, there are a number of Implementing routine PRO assessment involves a methodological and practical decisions to be made.

These include:

  1. Identifying the goals for collecting PROs in clinical practice
  2. Selecting the patients, setting, and timing of assessments
  3. Selecting the appropriate questionnaire(s) to use
  4. Choosing a mode for administering

Both the DHP-1 and DHP-18 have been developed for implementation in a range of settings including: clinical trials community& population surveys and clinical care in order for example to:

  • measure improvement or decline in the psychological and behavioural functioning of patients
  • screen for unmet need
  • assess treatment effectiveness
  • assess intervention programmes

Because of the range of settings and applications in which the DHP can be used, there is no one correct way in which the DHP should be implemented. However, for clinical trials, community and population surveys and research, implementation of the DHP must be in accordance with the study protocol.

Implementing  the DHP in a clinical setting

Staff in a clinical setting can be reluctant to implement patient reported outcome measures often due excessive work load or as in doing so reducing valuable consultation time. Therefore, to have a successful implementation strategy the following are important considerations that can aide implementation:

  • Good communication between all team members
  • A proactive approach that involves all members of the team
  • Demonstrating the the DHP adds value to the work of individuals within the team and organisation. For example, regular presentations to management demonstrate the effective of the service or how the DHP contributes to staff understanding and addressing a patient’s clinical needs
  • In-house training to ensure staff are competent in administering the measure

In the development of a diabetes-specific PROM implementation strategy, the following questions need to be addressed:

  1. How will the PROM fit into the clinical workflow?
  2. Will it include both type 1 and type 2 patients?
  3. How often should the PROM be administered?
  4. Who will receive the reports?
  5. How and when will the results be presented to the patient
  6. How will the results be used?

It is strongly recommended that the implementation strategy should take into account In the development of the strategy the delivery points in the diabetes care pathway for National Quality Standards in diabetes and the guidelines for the implementation of the DHP.

Diabetes care pathway

Image: Courtesy Year of Care Partnerships/Diabetes UK


guideline for implementing the Diabetes Health ProfileGuideline for implementing the Diabetes Health Profile

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