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Table 3 Quotes to accompany themes regarding PRM use

From: Can practitioners use patient reported measures to enhance person centred coordinated care in practice? A qualitative study

P3C Domains
Information and communication My goals/outcomes Care planning
1a) Facilitating the presentation of symptom change and current status “Some people find it really helpful to do the [PAM] and the [WEMWBS] because it gives them a tool for focusing their questions and how they’re feeling”. 2a) Self-management: PRMs can help practitioners identify issues and areas for improvement
“[The PAM] highlights areas they may think they are confident about, but in reality they’re not. If completed with conversation [you can] set goals to improve”.
4a) Supporting health practitioners to provide tailored care
“They have identified through this huge [PROM] database what is a really good treatment for this type of patient”.
“There was discussion about whether or not long-term conditions should include Dementia… We [said] you need to add that as a separate consideration [as it will involve] a completely different kind of tailored support and we want to be able to know what that looks like”.
1b) Enriched practitioner - patient conversations
“It helps the patient to identify things about their disease and about their health that may not surface otherwise if you don’t ask these questions”.
“We ask patients to do the Warwick and then right in front of us we can see a bit about how the patients feeling and lift a conversation out of that and say how does it make you feel to see what you’ve written down”.
“It’s very good for building up relationships actually, I know we moan about the paperwork, but sometimes you can get to know different sides to the person. It does make them more open to talking I think sometimes”.
2b) Empowerment
encouraging patient engagement in their care through PRMs
“As a diary – print them off put them into a folder… linking to it through their phone”.
“[PRM data] can improve their understanding of their disease and what we’re trying to measure … because this is an area that we think is important and should be important to you”.
“When they’re reporting and they seem to be getting better, but [their results show] they’re not, you can begin to work with the difference between the two”.
4b) PRMs enabling ongoing monitoring of patients’ condition and progress with treatment
“So we could have a threshold for a change, for example. So if you, you know, move by two points or one point or whatever, actually that then flags that on to another dashboard that says, this patient…and we can then run a telephone clinic potentially”.
1c) Creating communication pathways between healthcare services and patients; creating a more person-focused service
“We were able to say, look this is what patients actually want. This is where we’re not scoring so well, that we don’t provide access in that practice. So, they then turned around and said, okay we will fund”.
2c) “Headway made with personal goals
Let’s focus on a goal instead, let’s focus on you running the marathon each year and let’s see what we can do about that. So, let’s use the PROM and the PREM about this to see how things [get on]”.
4c) Using PRMs to keep care plans current and relevant
“It was more useful for the clinical changes to drive the frequency of outcome measures. So, we use a measure called Phase of Illness, which captures the context of the current illness; whether somebody is stable, unstable, deteriorating, or dying”.
1d) Generating pre-consultation communication
“Physicians can see [before the visit] okay, there are some things here that we need to take care of and can identify things about their disease”.
4d) PRMs enabling remote management of stable patients
“We’ve got cohorts of patients that we know are quite stable; they’re highly educated. They understand what’s required of them. Why do we need to see these patients in clinic or as frequently as we have been? Patients that aren’t terribly engaged, struggle with education and understanding around conditions - surely they’re the ones that we should be concentrating the resources and education on”.