Selecting Patient-Reported Measures (PRMs) For Patients with Multiple Conditions

In the intricate landscape of healthcare, where patients often grapple with multiple conditions simultaneously, the challenge of implementing patient-reported, condition-specific outcome measures can become a multifaceted puzzle. How do we select outcomes metrics encompassing clients' diverse needs with multiple conditions? This blog delves into the art and science of crafting comprehensive condition-specific patient-reported outcomes measures (known as PROMs) in the face of complexity.

Holistic approaches to condition-specific metrics

A holistic approach to setting up condition-specific metrics becomes imperative in the face of multifaceted health challenges. Rather than isolating metrics for each complication, healthcare professionals increasingly adopt comprehensive frameworks considering the interconnections between health issues. This approach allows for a more nuanced understanding of a client's health status, enabling tailored interventions that address their complications.

The role of personalisation and flexibility

Understanding the complexity of each individuals' health realities, which often involve multiple complications and comorbidities, is a fundamental aspect of modern healthcare. Healthcare providers must select appropriate metrics to capture this complexity while offering clear and actionable insights and personalised care.

Every patient’s health journey is unique and influenced by many factors. Setting up effective condition-specific metrics requires a personalised touch. Metrics should be adaptable, allowing healthcare providers to tailor them to each client's specific complications, severity levels, and individual goals. Personalised metrics empower clients, making them active participants in their healthcare by aligning their metrics with their aspirations for improved health and well-being.

Harnessing technology and data analytics

The digital age brings forth powerful tools like technology and data analytics. Advanced software solutions can process vast amounts of data, enabling healthcare providers to identify patterns, correlations, and trends among clients with multiple complications. Leveraging these insights, healthcare professionals can design metrics that capture the intricacies of diverse health challenges, fostering a more nuanced understanding of clients' conditions.

Which PROMs to use when people are diagnosed with multiple conditions?

Selecting PROMs becomes more complex when a patient has multiple chronic conditions. There isn't a one-size-fits-all answer because the choice of PROMs depends on the specific chronic conditions the patient is dealing with and the outcomes being assessed.

In cases of multiple chronic conditions, healthcare providers often use disease-specific PROMs tailored to each condition. These condition-specific PROMs allow a detailed understanding of the impact of each condition on the patient's quality of life and overall wellbeing.

Additionally, there are generic PROMs that assess general health-related quality of life. These generic measures, like the SF-36 or EQ-5D, can be used alongside condition-specific PROMs. They provide a broader perspective, capturing the overall health status and the impact of multiple conditions on the patient's daily life.

The choice of PROMs for patients with multiple chronic conditions should be individualised and based on the specific conditions being managed, the goals of treatment, and the aspects of health most relevant to the patient's and healthcare provider's concerns. It often involves a careful assessment and selection process, ensuring that the chosen PROMs align with the patient's unique health situation and the outcomes healthcare providers aim to measure and improve. The Australian Commission on Safety and Quality in Health Care suggests that "a standard approach is to use generic measures with supplementary specific measures" is a way to capitalise on the strengths of each PROM being used.

Multi-disciplinary team collaboration and knowledge sharing

The complexity of managing clients with multiple complications necessitates interdisciplinary collaboration. Healthcare professionals from various fields bring unique expertise to the table. By fostering a culture of knowledge-sharing and collaborative problem-solving, interdisciplinary teams can co-create holistic metrics that address the multifaceted nature of clients' health challenges. This collaborative approach ensures that the metrics designed are comprehensive but also practical and feasible in real-world healthcare settings.

Empowering clients in metric development

Lastly, empowering clients to participate in the development of their metrics actively is paramount. Clients are the experts of their own experiences and their insights are invaluable. Engaging clients in meaningful discussions about their health goals, challenges and preferences provides healthcare providers with essential qualitative data. This qualitative input and quantitative metrics provide a comprehensive picture of the client's health status, ensuring a more holistic and client-centred approach to care.

Conclusion: identifying compassionate and comprehensive metrics

In the face of complexity, the art of selecting condition-specific outcomes measures for clients with multiple complications lies in embracing a holistic, personalised and collaborative approach. By acknowledging the interconnected nature of health challenges, leveraging technology and valuing the input of both healthcare providers and clients, we can navigate the intricate landscape of healthcare, ensuring that the patient-reported outcomes measures selected are not just numbers but compassionate, comprehensive tools that truly make a difference in clients' lives.

Further Learning:

For further details on why measuring patient-reported outcomes and experiences will become important to your practice in the near future, watch our free Kickstarter webinar - Australian Health Reform: What it means for you and your practice here.

Further Reading:

ICHOM (International Consortium for Health Outcomes Measurement)

Selecting PROMs: Australian Commission on Safety and Quality in Health Care

Blog: The Fundamentals of Patient-Reported Measures.