Do patients have a say? A narrative review of the development of patient-reported outcome measures used in elective procedures for coronary revascularisation

Peeters, Geeske; Barker, Anna; Talevski, Jason; Ackerman, Ilana N.; Ayton, Darshini; Reid, Christopher M.; Evans, Sue; Stoelwinder, Johannes Uiltje; McNeil, John J

doi:10.1007/s11136-018-1795-6

Cited by 12 publications

(20 citation statements)

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“…This study was the final stage of a larger mixed-methods project (S1 Fig) that included a literature review, focus groups and interviews, and a discrete choice experiment (DCE) [20, 28, 29]. The methodology and results for these studies have been described in detail elsewhere and are briefly summarised below [20, 28, 29].…”

Section: Methodsmentioning

confidence: 99%

“…Recently, we conducted a mixed-methods project to identify outcomes most important to patients following PCI [20, 28, 29]. The primary aim of this study was to identify the final set of items that can be included in a PROM (the Monash University cardiac PROM [MC-PROM]) to assess recovery following PCI using the outcomes generated from previous studies.…”

Section: Introductionmentioning

confidence: 99%

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What matters most to patients following percutaneous coronary interventions? A new patient-reported outcome measure developed using Rasch analysis

et al. 2019

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Introduction Measuring patient reported outcomes can improve the quality and effectiveness of healthcare interventions. The aim of this study was to identify the final set of items that can be included in a patient-reported outcome measure to assess recovery of patients following percutaneous coronary interventions. Methods A consecutive sample of 200 patients registered in the Victorian Cardiac Outcomes Registry participated in a telephone survey 30 days following their percutaneous cardiac procedure. Rasch analysis was used to select the best set of items to form a concise and psychometrically sound patient-reported outcome measure. Key measurement properties assessed included overall fit to the Rasch measurement model, unidimensionality, response formats (thresholds), targeting, internal consistency and measurement invariance. Results Five items were identified as being reliable and valid measures of patient-reported outcomes: pain or discomfort, shortness of breath, confidence in performing usual activities, feeling unhappy and having trouble sleeping. Data showed overall fit to a Rasch model of expected item functioning (χ 2 16.99; p = 0.07) and all items demonstrated unidimensionality ( t -test less than 0.05 threshold value). Internal consistency was acceptable (equivalent Cronbach’s α 0.65) given there are only five items, but there was a ceiling effect (mean logit score -1.24) with compromised score precision for patients with better recovery. Conclusions We identified a succinct set of items that can be used in a patient-reported outcome measure following percutaneous coronary interventions. This patient-report outcome measure has good structural validity and acceptable internal consistency. While further psychometric evaluations are recommended, the items identified capture the patient’s perspective of their recovery following a percutaneous coronary intervention.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What matters most to patients following percutaneous coronary interventions? A new patient-reported outcome measure developed using Rasch analysis

et al. 2019

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“…A systematic search of the peer-reviewed literature was undertaken to identify existing cardiac PROMs. 17 Twenty-seven PROMs were identified yielding 430 symptoms and feelings that were used to develop topic guides for the focus groups and interviews. Further details on the methods and results of the literature review have been published elsewhere (refer to Peeters et al 17 ).…”

Section: Methodsmentioning

confidence: 99%

“… 12 Some collect generic quality of life measures but cardiac-specific PROMs are not routinely collected. The length of existing cardiac PROMs (up to 160 items) 17 18 may be a key factor in their limited uptake. In addition, a previous review highlighted that the patient perspective had often been overlooked in the development of PROMs for patients who had undergone elective coronary revascularisation.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, a previous review highlighted that the patient perspective had often been overlooked in the development of PROMs for patients who had undergone elective coronary revascularisation. 17 As such, instruments were not necessarily reflective of outcomes most important to patients, including only two of the three PROMs recommended by ICHOM. 12 19 …”

Section: Introductionmentioning

confidence: 99%

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Symptoms and feelings valued by patients after a percutaneous coronary intervention: a discrete-choice experiment to inform development of a new patient-reported outcome

et al. 2018

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ObjectiveTo inform the development of a patient-reported outcome measure, the aim of this study was to identify which symptoms and feelings following percutaneous coronary intervention (PCI) are most important to patients.DesignDiscrete-choice experiment consisting of two hypothetical scenarios of 10 symptoms and feelings (pain or discomfort; shortness of breath; concern/worry about heart problems; tiredness; confidence to do usual activities; ability to do usual activities; happiness; sleep disturbance; dizziness or light-headedness and bruising) experienced after PCI, described by three levels (never, some of the time, most of the time). Preference weights were estimated using a conditional logit model.SettingFour Australian public hospitals that contribute to the Victorian Cardiac Outcomes Registry (VCOR) and a private insurer’s claim database.Participants138 people aged >18 years who had undergone a PCI in the previous 6 months.Main outcome measuresPatient preferences via trade-offs between 10 feelings and symptoms.ResultsOf the 138 individuals recruited, 129 (93%) completed all 16 choice sets. Conditional logit parameter estimates were mostly monotonic (eg, moving to worse levels for each individual symptom and feeling made the option less attractive). When comparing the magnitude of the coefficients (based on the coefficient of the worst level relative to best level in each item), feeling unhappy was the symptom or feeling that most influenced perception of a least-preferred PCI outcome (OR 0.42, 95% CI 0.34 to 0.51, p<0.0001) and the least influential was bruising (OR 0.81, 95% CI 0.67 to 0.99, p=0.04).ConclusionThis study provides new insights into how patients value symptoms and feelings they experience following a PCI.

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Effects of an 18-month community-based, multifaceted, exercise program on patient-reported outcomes in older adults at risk of fracture: secondary analysis of a randomised controlled trial

et al. 2023

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Summary This study identified that an 18-month community-based, multifaceted, exercise program consisting of resistance, weight-bearing impact, and balance/mobility training combined with osteoporosis education and behavioural support can improve health-related quality of life (HRQoL) and osteoporosis knowledge in older adults at risk of fracture, but only for those adherent to the exercise regime. Purpose To evaluate the effects of an 18-month community-based exercise, osteoporosis education and behaviour change program ( Osteo-cise: Strong Bones for Life ) on HRQoL, osteoporosis knowledge and osteoporosis health beliefs. Methods This was a secondary analysis of an 18-month randomised controlled trial in which 162 older adults aged ≥ 60 years with osteopenia or increased falls/fracture risk were randomized to the Osteo-cise program ( n = 81) or control group ( n = 81). The program consisted of progressive resistance, weight-bearing impact and balance training (3 days/week); osteoporosis education to facilitate self-management of musculoskeletal health and behavioural support to enhance adherence to exercise. HRQoL, osteoporosis knowledge and osteoporosis health beliefs were assessed using the EuroQoL questionnaire (EQ-5D-3L), Osteoporosis Knowledge Assessment Tool and Osteoporosis Health Belief Scale, respectively. Results Overall, 148 participants (91%) completed the trial. Mean exercise adherence was 55% and mean attendance for the three osteoporosis educational sessions ranged from 63-82%. After 12 and 18 months, there were no significant effects of the Osteo-cise program on HRQoL, osteoporosis knowledge or health beliefs relative to controls. Per protocol analyses (≥ 66% exercise adherence; n = 41) revealed a significant net benefit in EQ-5D-3L utility for the Osteo-cise group relative to controls after 12 months ( P = 0.024) and 18 months ( P = 0.029) and a significant net improvement in osteoporosis knowledge scores at 18 months ( P = 0.014). Conclusion This study supports the importance of adherence to exercise regimes, as adherence to the Osteo-cise: Strong Bones for Life program was associated with improvements in HRQoL and osteoporosis knowledge in older adults at increased risk for falls and fractures. Trial registration number: ACTRN12609000100291. Supplementary Information The online version contains supplementary material available at 10.1007/s00198-023-06693-y.

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Do patients have a say? A narrative review of the development of patient-reported outcome measures used in elective procedures for coronary revascularisation

Cited by 12 publications

References 58 publications

What matters most to patients following percutaneous coronary interventions? A new patient-reported outcome measure developed using Rasch analysis

What matters most to patients following percutaneous coronary interventions? A new patient-reported outcome measure developed using Rasch analysis

Symptoms and feelings valued by patients after a percutaneous coronary intervention: a discrete-choice experiment to inform development of a new patient-reported outcome

Effects of an 18-month community-based, multifaceted, exercise program on patient-reported outcomes in older adults at risk of fracture: secondary analysis of a randomised controlled trial

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