Functionality and feedback: A realist synthesis of the collation, interpretation and utilisation of PROMs data to improve patient care

This project is funded by the NIHR HS&DR. Patient Reported Outcome Measures (PROMS) currently have a central role in UK health policy as a lever to drive up the quality of patient care.  Individual PROMs data can be fed back to clinicians and patients to inform care and treatment of patients and aggregated PROMs data can be fed back to clinicians, managers and commissioners to stimulate quality improvement initiatives and to patients to inform choice of provider.  PROMS feedback interventions are heterogeneous; they vary by PROM used, patient population, setting, format and timing of feedback, recipients of the information and level of aggregation of the data. Not surprisingly, systematic reviews of PROMs feedback have found a mixed pattern of outcomes and have struggled to provide guidance to NHS decision makers on the effectiveness of PROMS feedback.  Therefore, little guidance exists on the optimal use of PROMS feedback by commissioners, clinicians, managers and patients to improve the quality of patient care.

We aim to address this gap by conducting a different sort of review, termed realist synthesis (RS), to understand ‘what PROMS feedback interventions work for whom in what circumstances and in what respects’ in order to produce guidance for NHS decision makers on where and how best to utilise PROMs data to improve the quality of patient care.

Project team: Joanne Greenhalgh (PI), Ray Pawson, Sonia Dalkin, Judy Wright, David Meads (University of Leeds), Laurence Wood, Nick Black (LSHTM), Chema Valderas (University of Exeter), Elizabeth Gibbons (University of Oxford), Chris Mills (Leeds West CCG).