背景:慢性病与高疾病负担相关。医疗保健提供者之间的护理供应不足和过度以及质量差异仍然存在,而目前的质量指标很少能抓住患者的观点。捕获患者报告的结果测量(PROM)以及患者报告的经验测量(PREM)对于识别护理提供方面的差距变得越来越重要。优先考虑对患者最有价值的服务,帮助病人自我管理。
目的:本研究旨在评估以结构化和基于人群的方式使用电子患者报告结果测量(ePROMs)和电子患者报告经验测量的潜在益处和有效性,以增强德国慢性病患者的医疗保健。
方法:本前瞻性队列研究旨在评估慢性疾病患者使用PROM的潜在益处。我们评估是否(1)通过生成慢性哮喘患者的代表性反应,数字收集的PROM和PREM可用于卫生系统性能评估,慢性阻塞性肺疾病,糖尿病,和整个德国的冠状动脉疾病,和(2)基于PROM和PREM,可以识别低价值的护理。由于患者报告的结果(PRO)很少提供给患者,(3)本研究还以数字PRO反馈的形式检查了患者对PROM评分的反应。出于这些目的,从德国一家全国性保险公司随机选择的患者接受通用和疾病特异性PROM和PREM的数字调查,以及关于他们健康相关行为的其他问题,1年以上4次。在每个调查期后,将个人PRO反馈纵向地呈现给患者,并与同伴组进行比较。患者报告的数据与健康保险数据相关联。响应率,随着时间的推移,健康和经验结果的变化,自我报告的健康行为变化,将分析医疗保健系统的使用情况。
结果:PROM慢性研究探索了慢性疾病患者中PROM的使用。在最初的邀请函发布之后,数据收集于2023年10月开始。所有200,000名潜在患者已被邀请参加该研究。数据尚未分析。中期结果计划于2024年秋季公布,结果计划于2025年公布。
结论:我们的目标是填补慢性疾病患者中基于人群的PROM和PREM使用的研究空白,并增加目前对患者PROM数据共享的理解。因此,研究结果可以告知是否可以使用全医疗保健系统收集PROM和PREM的方法来识别低价值护理,评估慢性病内部和之间的质量变化,并确定PRO反馈是否有帮助并与患者健康行为的任何变化相关。
背景:德国临床试验注册DRKS00031656;https://drks。de/search/en/trial/DRKS00031656.
■DERR1-10.2196/56487。
BACKGROUND: Chronic diseases are associated with a high disease burden. Under- and overprovision of care as well as quality variation between health care providers persists, while current quality indicators rarely capture the patients\' perspective. Capturing patient-reported outcome measures (PROMs) as well as patient-reported experience measures (PREMs) is becoming more and more important to identify gaps in care provision, prioritize services most valuable to patients, and aid patients\' self-management.
OBJECTIVE: This study aims to measure the potential benefits and effectiveness of using electronic patient-reported outcome measures (ePROMs) and electronic patient-reported experience measures in a structured and population-based manner to enhance health care for chronic disease patients in Germany.
METHODS: This prospective cohort study aims to evaluate the potential benefits of PROM usage in patients with
chronic diseases. We evaluate whether (1) digitally collected PROMs and PREMs can be used for health system performance assessment by generating a representative response of chronically diseased individuals with asthma, chronic obstructive pulmonary disease, diabetes, and coronary artery disease across Germany, and (2) based on the PROMs and PREMs, low-value care can be identified. As patient-reported outcomes (PROs) are rarely presented back to patients, (3) this study also examines patients\' reactions to their PROM scores in the form of digital PRO feedback. For these purposes, randomly selected patients from a nationwide German insurer are digitally surveyed with generic and disease-specific PROMs and PREMs, as well as additional questions on their health-related behavior, 4 times over 1 year. Individual PRO feedback is presented back to patients longitudinally and compared to a peer group after each survey period. Patient-reported data is linked with health insurance data. Response rates, changes in health and experience outcomes over time, self-reported changes in health behavior, and health care system usage will be analyzed.
RESULTS: The PROMchronic study explores the usage of PROMs in patients with
chronic diseases. Data collection began in October 2023, after the initial invitation letter. All the 200,000 potential patients have been invited to participate in the
study. Data have not yet been analyzed. Publication of the interim results is planned for the autumn of 2024, and the results are planned to be published in 2025.
CONCLUSIONS: We aim to fill the research gap on the population-based usage of PROMs and PREMs in patients with chronic diseases and add to the current understanding of PROM data-sharing with patients. The study\'s results can thereby inform whether a health care system-wide approach to collecting PROMs and PREMs can be used to identify low-value care, assess quality variation within and across chronic conditions, and determine whether PRO feedback is helpful and associated with any changes in patients\' health behaviors.
BACKGROUND: German Clinical Trials Register DRKS00031656; https://drks.de/search/en/
trial/DRKS00031656.
UNASSIGNED: DERR1-10.2196/56487.