Bridging the Gap: Exploring the Use of Patient-Reported Outcome Measures in Clinical Care Settings

Abstract

Monitoring symptoms and quality of life can provide important information to clinicians to optimise the management of their patient’s chronic condition(s). Patient-reported outcomes (PROs) are patient self-reports on health outcomes such as disease symptoms, treatment side effects, and health-related quality of life. Traditionally used in research settings, there is growing interest in their application in clinical care to enhance communication between patients and clinicians, reduce symptom burden, improve quality of life, and inform health service redesign.

Despite their potential, gaps remain in our understanding of specific strategies to increase PRO measure (PROM) completion by people from culturally and linguistically diverse (CALD) backgrounds and Indigenous Peoples. Additionally, how PROs are captured and actioned in the care of patients with kidney failure is underexplored. Chapter 2 aimed to identify facilitators of PROM completion by people who are CALD and Indigenous Peoples and offer evidence-based recommendations for healthcare providers and policymakers, putting findings in the context of an existing program of PROM collection implemented in New South Wales, Australia. Chapter 3 aimed to understand practices for assessing, monitoring, and managing kidney failure symptoms in Australian haemodialysis units.

This thesis highlights: 1) the limited global strategies to encourage PROM completion by people who are CALD and Indigenous Peoples, and 2) what ‘usual care’ is for assessing, managing and actioning PROs for patients with kidney failure and why (or why not) PROs are assessed in this context.