Patient Reported Outcome Measures provide an insight from the patient's perspective of the impact of diasease and treatment on their health and quality of life.
4. “ Despite a century of developments in medical technology, and vast improvements in the ability of medical science to prevent, diagnose and treat disease and ill health, attempts to measure the outputs of health care in terms of their impact on patients’ health have not progressed beyond Florence Nightingale’s time.” Getting the most out of PROMs Kings Fund 2010
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6. … the NHS will be the first health care system in the world to measure what it produces in terms of health , rather than in terms of the production of health care. Getting the most out of PROMs Kings Fund
8. Health Outcomes – A definition “ Outcomes, by and large, remain the ultimate validation of the effectiveness and quality of medical care." Avedis Donabedian 1966
9. The ultimate measure by which to judge the quality of medical effort is whether it helps patients (and their families), as they see it. Berwick 1997
10. But!! “ Different perspectives on outcomes need to be acknowledged. For instance, patients, carers and clinical staff may have different views of what outcomes are important, how you would measure them, and even which were desirable” Long A, Jefferson J 1999
21. What are the opportunities that PROM data presents?
22. PROM Stakeholders Government Charities Professional bodies Providers Patients Commisioners Health care professionals Pharma PROMs
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26. Hypothetical example of benefits of treatment 25 30 45 50 55 60 65 70 75 Anxiety summary score (higher scores better health) Pre-treatment 3 months later People of similar age & treatment UK sample
27. Linking PROM Research, guidelines & Routine practice Guidelines based on research outcomes Routine practice Research using PROMs
40. What does the DHP Measure? Psychological distress Barriers to activity Disinhibited eating dysphoric mood, irritability, feelings of hopelessness anxiety, perceived impairment, restrictions in activity Lack of eating restraint, eating in response to emotional arousal and external food cues
41. Two versions of the DHP DHP-18 18-items DHP-1 32-items Type1 and insulin requiring Type 1 & Type 2 including tablet, diet
42. DHP-18 Conceptual Framework Psychological distress Lose temper/shout Moody due to diabetes Lose temper over testing Lose temper over small things More arguments at home Days tied to meal times Food controls life Difficult staying out late Worry about colds and flu Get edgy when nowhere to eat Don’t go out when sugars are low Depressed due to diabetes Worry going into busy shops Eat to cheer self up Hard saying no to food Eat extra when bored/fed up Not so many nice things to eat Easy to stop eating Barriers to activity Disinhibited eating
43. How is the DHP scored? Items scored using 4-point Likert type scale (range 0-3) Standardised subscale scores 0 (no dysfunction) thru 100 (max dysfunction) Standardised populations means
44. DHP-18 - Description of very high and very low BA, PD and DE scale scores Absence of eating in response to food cues and or emotional arousal. No excessive eating. Substantial and or frequent levels of eating in response to food cues and emotional arousal. Excessive eating. DE Little or absence of restricting anxiety or perceived limitations in social/roles Very significant levels of anxiety restricting behaviour and perceived limitations in social/role activities BA None or little experienced lowered mood or feelings of expressed hostility Frequent and or substantial emotional distress including dysphoric mood, irritability and externally directed hostility PD Very low Very high Scale
45. If you would like to discuss how DHP Research can help you to use and analyse Patient Reported Outcomes for healthcare, pharmaceutical or biotech, or would like more information on the DHP, please get in touch. Email: [email_address] Mobile: +44 (0) 796 022 8124 Tel: +44 (0) 208 467 3739 Website: www.dhpresearch.com Linkedin: http://url.ie/92wf