Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 27, 2024
Open Peer Review Period: Jul 3, 2024 - Aug 28, 2024
Date Accepted: Mar 3, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Electronic implementation of patient-reported outcome measures in primary health care - a mixed method systematic review.
ABSTRACT
Background:
Managing chronic diseases remains a significant challenge in OECD countries. Digital tools, especially electronic PROMs (ePROMs), have shown potential in improving data collection and healthcare delivery but their implementation in primary health care is still scarce.
Objective:
We aimed to describe the implementation and effectiveness of ePROMs in chronic disease management in primary health care settings and to identify associated barriers and facilitators.
Methods:
We conducted a mixed-method systematic review following Cochrane Methods and PRISMA guidelines, including studies that implemented ePROMs among adults to manage chronic diseases. We extracted outcomes related to patient health, provider workflow, costs, and implementation factors. We used the RE-AIM Framework to assess the reach, efficacy, adoption, implementation, and maintenance of ePROMs.
Results:
Our search yielded 12,168 references, from which 22 studies were included after screening and exclusions. These studies, conducted mainly in the United States and Canada, covered various chronic diseases and utilized diverse ePROMs tools, primarily mobile applications. While some studies reported improvements in patient health outcomes and self-management, others indicated no significant change. Barriers included digital literacy and integration into existing workflows, whereas facilitators involved personalized approaches and existing patient-provider relationships.
Conclusions:
Success in implementing ePROMs in primary health care appears to hinge on addressing digital literacy, ensuring personalization and meaningful patient-provider interactions, carefully integrating technology into clinical workflows, and conducting thorough research on their long-term impacts and cost effectiveness. Future efforts should focus on these areas to fully realize the benefits of digital health technologies for patients, providers, and healthcare systems. Clinical Trial: PROSPERO Systematic Review Registry (ID: CRD42022333513).
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.