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首页> 外文期刊>Patient Preference and Adherence >Core Patient-Reported Outcomes (PROs) and PRO Measures (PROMs) for Polypharmacy Medicines Reviews: A Sequential Mixed-Methods Study
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Core Patient-Reported Outcomes (PROs) and PRO Measures (PROMs) for Polypharmacy Medicines Reviews: A Sequential Mixed-Methods Study

机译：核心患者报告的结果（PROS）和Pro措施（PROMS）用于多酚药物的评论：一项顺序混合方法研究

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Purpose: Problematic polypharmacy can exaggerate “medicine burden” for the patient. Patient-reported outcomes (PROs) are key indicators of medicine burden, and PRO measures (PROMs) can help patients articulate their perceptions of medicine burden. We aimed to: (a) evaluate what PROMs currently exist that assess medicine burden, and what PROs they target, and (b) understand patients’ experiences with using multiple medicines to establish a core set of most meaningful and relevant PROs for assessment in polypharmacy medicines reviews. Patients and Methods: We conducted a prospective, sequential mixed-methods study in two consecutive work phases. Phase 1 involved a rapid review of PROMs, informed by the published PRISMA and COSMIN initiative guidelines. We integrated all evidence in a thematic narrative synthesis. Phase 2 involved cross-sectional, one-to-one, semi-structured interviews with key stakeholders, including members of the public and healthcare professionals (HCPs). We conducted thematic content analysis to identify and classify emerging PROs. Results: In Phase 1, 13 studies described the development and/or validation of 12 PROMs. The PROMs targeted 14 content domains of adult patients’ experiences with prescribed medicines. PROMs varied widely in terms of length, comprehensiveness and psychometric robustness. In Phase 2, all participants (seven members of the public; eight HCPs) agreed on the clinical relevance of PROMs, providing a rich account of justifications. We identified four core PROs: ‘Knowledge, information and communication about own medicines’; “Perceptions, views and attitudes about (own) medicines”; “Impact on daily living: Side-effects and practicalities”, and “Medicine usage: ‘as planned’, misuse, abuse, no use”. Conclusion: We suggest combining psychometrically robust PROMs or domains across PROMs into a bespoke PROM that addresses comprehensively and succinctly the four core PROs. We recommend a careful implementation process that must involve consultation with all relevant stakeholders, while establishing a clear purpose for collecting a PROM and realistic and ongoing collection at key time-points.
机译：目的：有问题的PolyPharmacy可以夸大患者的“医学负担”。患者报告的结果（优点）是医学负担的关键指标，专业措施（PROMS）可以帮助患者阐明他们对医学负担的看法。我们的目标是：（a）评估目前存在评估医学负担的舞会，以及他们靶向的优势，（b）了解患者使用多种药物来建立一个核心的多药物评估核心案件的经验药物评论。患者和方法：我们在两个连续的工作阶段进行了一项前瞻性的序贯混合方法研究。第1阶段涉及出版的Prisma和Cosmin倡议准则的迅速审查竞争。我们在主题叙事综合中纳入所有证据。第2阶段涉及与主要利益相关者的横断面，一对一，半结构性访谈，包括公众和医疗保健专业人员（HCP）的成员。我们进行了主题内容分析以识别和分类新兴专业人员。结果：在第1阶段，13阶段研究描述了12个裁判的发展和/或验证。 PROMS针对成年患者的14个内容域与规定药物的经验。舞会在长度，全面性和心理上的稳健性方面变化广泛。在2阶段，所有参与者（公众的七名成员;八个HCP）同意PROM的临床相关性，提供丰富的理由。我们确定了四个核心优势：“对自己的药物的知识，信息和沟通”; “关于（自己）药物的看法，观点和态度”; “对日常生活的影响：副作用和实用”，以及“药物用法：”计划“，滥用，滥用，不使用”。结论：我们建议将跨舞会的精神统治性竞争或域组合成一个定制的PROM，以全面和简洁地解决四个核心专利。我们建议一个仔细的实施过程，必须涉及与所有相关利益攸关方进行磋商，同时在关键时间点建立明确的目的，以便收集舞会和现实和持续的收集。

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