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Original research
Primary care physician’s (PCP) perceived value of patient-reported outcomes (PROs) in clinical practice: a mixed methods study
  1. Danny Mou1,
  2. Daniel M Horn2,
  3. Marilyn Heng3,
  4. Manuel Castillo-Angeles4,
  5. Keren Ladin5,
  6. Daniel Frendl6,
  7. Manraj Kaur7,
  8. Marcela del Carmen2,
  9. Thomas Dean Sequist8,
  10. Rachel C Sisodia2
  1. 1Physician Organization, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Massachusetts General Hospital Department of Orthopaedic Surgery, Boston, Massachusetts, USA
  4. 4Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
  5. 5Occupational Therapy and Community Health, Tufts University, Medford, Massachusetts, USA
  6. 6Urology, Massachusetts General Hospital, Boston, Massachusetts, USA
  7. 7Patient Reported Outcomes, Value, and Experience (PROVE) Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
  8. 8Mass General Brigham, Boston, Massachusetts, USA
  1. Correspondence to Dr Danny Mou, Physician Organization, Massachusetts General Hospital, Boston, Massachusetts, USA; dmou2{at}partners.org

Abstract

Background Patient-reported outcomes (PROs) can promote patient engagement, shared-decision making and improve the overall experience of care. However, PRO integration in the primary care clinical setting is limited. Exploring the perspectives of primary care physicians (PCPs) on PROs is key to understanding how they are being used in the clinical setting. We sought to elucidate this clinical perspective at one of the largest US health systems that has integrated a wide range of PROs into routine primary care.

Methods Mixed methods study with both anonymous online surveys and in-person qualitative semistructured interviews conducted with PCPs to understand their clinical perspectives on the applications of the existing PROs. PCPs from the 19 affiliated clinics were prompted to complete the survey. Interviewed PCPs were selected via a combination of random and purposive selection from the PCP directory.

Results Of 172 PCPs, 117 (68%) completed the online survey and 28 completed semistructured interviews. Most PCPs (77%) reviewed PRO responses with their patients. PCPs endorsed that PROs improve clinic efficiency and clinical management. However, PCPs have heterogeneous perspectives on the relevance of PROs in clinical practice, likely due to variations in clinic practice. For specific PRO instruments, PCPs reported anxiety and depression screening PROs to be most helpful. PCPs felt that PROs assisted with completing screening questions that are required by regulatory bodies. Barriers to using PROs include poor user-interface for both clinicians and patients and inadequate training.

Conclusions Most PCPs regularly use PRO data though there are mixed opinions about their clinical relevance. An adaptable, user-friendly PRO system has the potential to have meaningful clinical applications in primary care.

  • primary care
  • implementation science
  • patient-centred care
  • quality improvement
  • qualitative research

Data availability statement

Data are available on reasonable request. Deidentified data will be made available to those who request it for one year after the publication from the corresponding author.

https://doi.org/10.1136/bmjqs-2020-012206

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    Data availability statement

    Data are available on reasonable request. Deidentified data will be made available to those who request it for one year after the publication from the corresponding author.

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    Footnotes

    • DM and DMH are joint first authors.

    • Twitter @DannyMouMD, @danielmhorn, @marilyn_heng

    • DM and DMH contributed equally.

    • Contributors All authors contributed to the planning, conduct, analysis and writing of this study. DM is the guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. If allowed, DM and DMH should be listed as cofirst authors as they have contributed equally to the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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