Facing the challenges of PROM implementation in Dutch dialysis care: Patients' and professionals' perspectives

Wim S. Sipma*, Margriet F.C. de Jong, Yvette Meuleman, Marc H. Hemmelder, Kees C.T.B. Ahaus

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: Patient Reported Outcome Measures (PROMs) are increasingly used in routine clinical practice to facilitate patients in sharing and discussing health-related topics with their clinician. This study focuses on the implementation experiences of healthcare professionals and patients during the early implementation phase of the newly developed Dutch set of dialysis PROMs and aims to understand the process of early implementation of PROMs from the users' perspectives. METHODS: This is a qualitative study among healthcare professionals (physicians and nursing staff: n = 13) and patients (n = 14) of which 12 were receiving haemodialysis and 2 peritoneal dialysis. Semi-structured interviews were used to understand the barriers and facilitators that both professionals and patients encounter when starting to implement PROMs. RESULTS: The early PROM implementation process is influenced by a variety of factors that we divided into barriers and facilitators. We identified four barriers: patient´s indifference to PROMs, scepticism on the benefits of aggregated PROM data, the limited treatment options open to doctors and organizational issues such as mergers, organizational problems and renovations. We also describe four facilitators: professional involvement and patient support, a growing understanding of the use of PROMs during the implementation, quick gains from using PROMs such as receiving instant feedback and a clear ambition on patient care such as a shared view on patient involvement and management support. CONCLUSIONS: In this qualitative study carried out during the early implementation phase of the Dutch dialysis PROM set, we found that patients did not yet consider the PROM set to be a useful additional tool to share information with their doctor. This was despite the professionals' primary reason for using PROMs being to improve patient-doctor communication. Furthermore, the perceived lack of intervention options was frustrating for some of the professionals. We found that nurses could be important enablers of further implementation because of their intensive relationship with dialysis patients.

Original languageEnglish
Article numbere0285822
JournalPLoS ONE
Volume18
Issue number5 May
DOIs
Publication statusPublished - 15 May 2023

Bibliographical note

Funding Information:
This study was supported by the Netherlands Patients Federation: https://www. patientenfederatie.nl/netherlands-patientsfederation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors gratefully acknowledge Hans Bart and Karen Prantl (Dutch Kidney Patients Association) for their cooperation and support in making this research possible.

Publisher Copyright:
© 2023 Sipma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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