Patient-Reported Outcome and Experience Measures (PROM/PREM) in Patients Undergoing Liver Surgery with Enhanced Recovery after Surgery (ERAS®): An Exploratory Study

Healthcare (Basel). 2024 Mar 11;12(6):629. doi: 10.3390/healthcare12060629.

Abstract

Background: ERAS® (Enhanced Recovery after Surgery) is an evidence-based multidisciplinary approach focusing on optimizing outcomes after surgery through structured clinical pathways. This study aimed to assess patient-reported outcome and experience measures (PROM/PREM), which are not routinely assessed after liver surgery within an ERAS® protocol.

Methods: Routine outcome parameters were extracted from clinical documentation. Using qualitative content analysis, PROM and PREM were retrospectively identified in 13 case records. In a prospective survey of 10 participants, PROM was assessed at three timepoints using the EQ-5D-5L questionnaire. PREM were collected at discharge.

Results: The following PROM categories occurred in the retrospective content analysis: appetite (84.6%), pain/discomfort (76.9%), mobility (69.2%), wound condition (69.2%), and weight (61.5%). The categories of continuity of care (92.0%) and information, communication, education (69.0%) emerged as PREM. Descriptive changes in health state were shown for all EQ-5D-5L dimensions and timepoints. At discharge, mobility, selfcare, usual activities, and pain/discomfort tended to be worse, whereas anxiety/depression decreased gradually from preoperatively to the 4 week follow-up. There was high satisfaction with interprofessional care services and experienced cooperation between professionals.

Conclusions: PROM and PREM are helpful to incorporate patients' perspectives after liver surgery within an ERAS® pathway and should be collected routinely in clinical practice.

Keywords: ERAS; PREM; PROM; enhanced recovery after surgery; liver surgery.

Grants and funding

This research received no external funding.