JMIR Publications

ABSTRACT

Background:

The use of patient-reported outcome measures (PROMs) as a clinical tool for screening and decision-making has gained widespread interest with numerous implementation activities across specialties, even though the evidence has not been clear until now.

Objective:

The aim of this study was to assess the evidence for using patient-reported outcome measures (PROMs) in clinical practice for patients with diabetes, chronic obstructive pulmonary disease, heart disease, rheumatoid arthritis, and inflammatory bowel disease.

Methods:

Systematically review of the published randomized controlled trials on the use of PROMs for clinical purposes such as systematic PROM assessment alone or with a predefined PROM-based decision-making method. We searched the following databases: PubMed/MEDLINE, CINAHL, EMBASE, and Web of Science until February 2023. Two investigators independently screened titles, abstracts, and relevant full texts. Three investigators completed data extraction and risk of bias assessment.

Results:

The search yielded 21,203 articles, 686 full-text articles were screened, and 56 original studies were included in the review. The studies included patients with hearts diseases (n=17), chronic obstructive pulmonary disease (n=13), diabetes (n=10), inflammatory bowel disease (n=9), rheumatoid arthritis (n=6), and patients with mixed diagnoses (n=1). Endpoints included health care use, mortality, symptoms, and quality of life. Thirteen studies found a positive effect on different endpoints, and seven studies had low risk of bias.

Conclusions:

The evidence base for clinical use of PROMs is sparse. The clinical use of PROMs does not appear superior to usual care in the five included chronic diseases on any endpoint. The six PROM interventions with positive effect and low risk of bias are characterized by symptom assessment with predefined cut-offs used for decision and dialogue support. Clinical Trial: PROSPERO on 18/12/2020 (reg. no. CRD42021226896)