Patient-Reported Outcome Measures (PROMs) to Support Adherence to Falls Prevention Clinic Recommendations: A Qualitative Study

Daria Tai; Eric Li; Teresa Liu-Ambrose; Nick Bansback; Mohsen Sadatsafavi; Jennifer C Davis

doi:10.2147/PPA.S269202

Patient-Reported Outcome Measures (PROMs) to Support Adherence to Falls Prevention Clinic Recommendations: A Qualitative Study

Patient Prefer Adherence. 2020 Oct 30:14:2105-2121. doi: 10.2147/PPA.S269202. eCollection 2020.

Authors

Daria Tai^{1

2

3

4}, Eric Li¹, Teresa Liu-Ambrose^{2

3

4}, Nick Bansback^{5

6}, Mohsen Sadatsafavi^{7

8}, Jennifer C Davis^{1

2

3}

Affiliations

¹ Social & Economic Change Laboratory, Faculty of Management, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada.
² Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
³ Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.
⁵ School of Population and Public Health, University of British Columbia - Vancouver, Vancouver, British Columbia, Canada.
⁶ Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Faculty of Pharmaceutical Sciences, University of British Columbia - Vancouver, Vancouver, British Columbia, Canada.
⁸ Collaboration for Outcomes Research and Evaluation, University of British Columbia, Vancouver, British Columbia, Canada.

Abstract

Purpose: We examined how patient-reported outcome measures (PROMs) support patients' adherence to fall prevention recommendations in a novel primary care setting - the Falls Prevention Clinic.

Patients and methods: Using a patient-oriented qualitative study design, we recruited patient partners to our study team to assist in developing focus group prompts. A trained facilitator conducted five semi-structured interviews with a total of 21 Falls Prevention Clinic participants. A trained facilitator prompted participants about: their views on the EuroQol 5 domain - 5 level (EQ-5D-5L) PROM, their preferences for PROM administration and feedback, the presentation of PROM questionnaire data, the use of comparative data and the EQ-5D-5L in improving adherence to recommendations, and other information they would need to improve adherence. Participants' responses were coded according to three stages of qualitative analysis: open, axial and selective coding using an iterative and comparative approach.

Results: "Opportunity" and "Development" emerged as higher-level themes for the participants' perspectives on how the EQ-5D-5L may be helpful for their appointments. "Frequency" described how often the participants believed the EQ-5D-5L should be administered and feedback provided. "Challenges", "Benefits", "Patients' Understanding", "Relevance of Data", and "Usefulness of Data" provided insight on how PROMs data presentation was viewed by patients. "Performance", "Resources", "Knowledge", "Role in Behaviour Change" highlighted the participants' ideas for the role of the EQ-5D-5L and additional information in supporting their adherence to falls prevention recommendations. Participants emphasized that patients would value further support information to facilitate their adherence.

Conclusion: This patient-oriented qualitative study, among individuals at high risk of future falls, sheds light on the importance of timely, understandable feedback, integrated with other clinical feedback in supporting adherence.

Keywords: EQ-5D-5L; adherence; administration; falls; patient-physician communication; self-awareness.

Grants and funding

We acknowledge financial support for this project from the BC SUPPORT Unit Health Economics and Simulation Modelling (HESM) Methods Cluster (Award Number: HESM201), which is part of British Columbia’s Academic Health Science Network. The BC SUPPORT Unit receives funding from the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research. JCD is a Michael Smith Foundation for Health Research Career Scholar. TLA is a Canada Research Chair (Tier 2) in Physical Activity, Mobility, and Cognitive Neuroscience.