Patient-reported outcomes: pathways to better health, better services, and better societies

• Published in: Quality of life research 2016-05, Vol.25 (5), p.1103-1112
• Main Authors: Black, N., Burke, L., Forrest, C. B., Sieberer, U. H. Ravens, Ahmed, S., Valderas, J. M., Bartlett, S. J., Alonso, J.
• Format: Article
• Language: English
• Subjects: Adolescents; Avaluació; Clinical outcomes; Clinical trials; COMMENTARY; Decision making; Delivery of Health Care; Descriptive labeling; FDA approval; Health care delivery; Health care industry; Health care outcome assessment; Health outcomes; Health services; Health Status; Health surveillance; Health surveys; Humans; Medicine; Medicine & Public Health; Mental health; Patient care; Patient Outcome Assessment; Patients; Pediatrics; Population; Program Evaluation; Public Health; Quality Assurance, Health Care; Quality Improvement; Quality of care; Quality of Life; Quality of Life Research; Regulatory approval; School age children; Self evaluation; Serveis sanitaris; Sociology; Wellbeing
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-015-1168-3

While the use of PROs in research is well established, many challenges lie ahead as their use is extended to other applications. There is consensus that health outcome evaluations that include PROs along with clinician-reported outcomes and administrative data are necessary to inform clinical and policy decisions. The initiatives presented in this paper underline evolving recognition that PROs play a unique role in adding the patient perspective alongside clinical (e. g., blood pressure) and organizational (e. g., admission rates) indicators for evaluating the effects of new products, selecting treatments, evaluating quality of care, and monitoring the health of the population. In this paper, we first explore the use of PRO measures to support drug approval and labeling claims. We critically evaluate the evidence and challenges associated with using PRO measures to improve healthcare delivery at individual and population levels. We further discuss the challenges associated with selecting from the abundance of measures available, opportunities afforded by agreeing on common metrics for constructs of interest, and the importance of establishing an evidence base that supports integrating PRO measures across the healthcare system to improve outcomes. We conclude that the integration of PROs as a key end point within individual patient care, healthcare organization and program performance evaluations, and population surveillance will be essential for evaluating whether increased healthcare expenditure is translating into better health outcomes.