153 Assessment of the KLIK PROM portal implementation Introduction Patient-Reported Outcome Measures (PROMs) are standardized, validated questionnaires that are completed by patients, such as a person’s perspective on their health, well-being or symptoms [1,2]. PROMs can be used for several purposes: at group level to study differences between disease populations, to describe the effects of treatment in clinical trials, and to assess quality of care or on an individual level to promote patient-centered care, guide clinical decision-making and to facilitate communication [3]. There is widespread evidence for the effects of PROM applications on an individual level regarding an increase in Health-related Quality of Life (HRQOL) scores, satisfaction with care and communication about PROs in research settings, both in adult [4-6] and pediatric [7-12] samples. Yet the implementation of these evidence-based (EB) PROMs interventions is challenging. The KLIK PROM portal (www.hetklikt.nu and www.klik-uk.org) is an example of an EB PROM intervention for patients (children or adults) who regularly visit the outpatient clinic [13]. Patients complete PROMs online, prior to their visit. Answers are transformed into an electronic PROfile (ePROfile; Fig 1). Clinicians discuss this ePROfile with patients, to monitor well-being over time, identify problems, and provide tailored advice and interventions. The effects of using the KLIK PROM portal have been demonstrated in pediatric oncology [7] and in pediatric rheumatology [12], by showing an increased and more detailed discussion of HRQOL and psychosocial functioning during the consultation, less undetected problems, and a higher clinician-reported satisfaction with provided care, without lengthening the consultation duration. Despite the availability of several EB PROM interventions across the world, the actual implementation of PROM interventions in clinical practice remains limited [14-17]. There is a critical gap in behavioral medicine between what we know can optimize patient health and care outcomes and what gets implemented in everyday practice [1]. If EB PROM interventions are not successfully implemented in clinical practice, then intended effects are not reached, which limits the impact on patients’ health outcomes [18,19]. Traditional randomized controlled trials study the effectiveness of PROM interventions under ideal circumstances. Yet for the implementation of PROMs in clinical practice, a different, more flexible approach is needed. Often, a “voltage drop” (a dramatic decrease in effectiveness) is seen once interventions get implemented in clinical practice [20]. Implementation research is defined by the National Institute of Health as the “scientific study of the use of strategies to adopt and integrate evidence-based health interventions into clinical and 6
RkJQdWJsaXNoZXIy MTk4NDMw