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  1. Article ; Online: National initiative to promote public involvement in medicine safety: the use of a cross-sectional population survey to identify candidate behaviours for intervention development in Scotland.

    Gangannagaripalli, Jaheeda / McIver, Laura / Abutheraa, Nouf / Brewster, Richard / Dixon, Diane / Watson, Margaret C

    BMJ open

    2023  Volume 13, Issue 5, Page(s) e058966

    Abstract: Objectives: The aim of this study was to explore the public's current awareness of the safe use of medicines in general, and over-the-counter (OTC) analgesics (painkillers) in particular, as well as their information-seeking and advice-seeking, medicine ...

    Abstract Objectives: The aim of this study was to explore the public's current awareness of the safe use of medicines in general, and over-the-counter (OTC) analgesics (painkillers) in particular, as well as their information-seeking and advice-seeking, medicine use and disposal.
    Setting: General population, Scotland.
    Participants: Adults (aged >16 years) living in Scotland.
    Interventions: A cross-sectional survey was undertaken in collaboration with Ipsos MORI (a market research company). The content was informed by a multi-stakeholder prioritisation event and supplemented with information from earlier studies.
    Results: The survey was completed in March 2020 by 1000 respondents, most of whom had used a pharmacy in the previous 12 months to obtain a medicine. Of the 1000 respondents, 39% (n=389) were 55 years and over; 52% (n=517) were women; and 58% were degree-educated.On receipt of a new prescription, up to 29.8% (95% CI 27.0% to 32.7%) of respondents proactively sought specific information or advice from the pharmacist. Few (5.2% (95% CI 4.0% to 6.8%) respondents 'always' discussed their new prescription medicine with pharmacy staff and 28.9% (95% CI 26.2% to 31.8%) reported 'never' engaging in this behaviour. Respondents aged >35 years were less likely to engage in this behaviour.Just over half (53% (95% CI 50.5% to 56.7%)) the respondents reported oral OTC analgesic use at least once in the previous month.In terms of medicine disposal, 29.3% (95% CI 26.6% to 32.2%) of respondents considered waste bin disposal to be of low or no harm.
    Conclusions: This study identified low levels of information-seeking and advice-seeking from pharmacy personnel especially on receipt of new prescription medicines. Potentially unsafe behaviours were identified in the use and disposal of medicines. These results will inform the development of interventions to promote advice-seeking and increase awareness regarding safe medicine use.
    MeSH term(s) Adult ; Humans ; Female ; Male ; Cross-Sectional Studies ; Community Pharmacy Services ; Scotland ; Pharmacy ; Surveys and Questionnaires ; Nonprescription Drugs ; Prescription Drugs
    Chemical Substances Nonprescription Drugs ; Prescription Drugs
    Language English
    Publishing date 2023-05-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-058966
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  2. Article ; Online: Development of 2 Short Patient-Report Questionnaires of Patient Safety in Primary Care.

    Mounce, Luke T A / Salema, Nde-Eshimuni / Gangannagaripalli, Jaheeda / Ricci-Cabello, Ignacio / Avery, Anthony J / Kadam, Umesh T / Valderas, José M

    Journal of patient safety

    2022  Volume 18, Issue 3, Page(s) 161–170

    Abstract: Objectives: The Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) is a valid and reliable instrument (61 items across 5 domains) of patients' perceptions of safety. Stakeholder feedback has supported shorter versions for ... ...

    Abstract Objectives: The Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) is a valid and reliable instrument (61 items across 5 domains) of patients' perceptions of safety. Stakeholder feedback has supported shorter versions for improving choice and facilitating uptake of routine patient-centered evaluation. We sought to develop 2 shorter versions of PREOS-PC: one including the shortest possible scales that met established measurement performance standards and a screening version including a single item per domain.
    Methods: A total of 1244 patients from 45 general practices across England completed PREOS-PC questionnaires. All scale items in PREOS-PC underwent Item Response Theory analysis, applying standard criteria for the item reduction. Cognitive debriefing from 10 patient interviews allowed for the assessment of the instruments' readability. The instruments' psychometrics properties were reassessed in a validation sample of 1557 patients in 21 English general practices.
    Results: "PREOS-PC Compact" includes 25 items and 2 open-ended questions across the 5 domains, 44% of the length of the original instrument. "PREOS-PC Screen" consists of 6 items: the best-performing single items for 2 domains, 1 item modified from original items for each of the remaining 3 domains, and 1 open-ended question. The evaluation of the instruments confirmed they were acceptable to patients and met standards for readability; construct, convergent, and divergent validity; and reliability.
    Conclusions: PREOS-PC Compact meets high-performance standards while reducing patient burden for routine monitoring of patient safety in primary care. PREOS-PC Screen is a concise tool apt for incorporation into audits and to target more in-depth review as needed.
    MeSH term(s) Humans ; Patient Safety ; Primary Health Care ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires
    Language English
    Publishing date 2022-03-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2394324-5
    ISSN 1549-8425 ; 1549-8417
    ISSN (online) 1549-8425
    ISSN 1549-8417
    DOI 10.1097/PTS.0000000000000880
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  3. Article ; Online: Identifying Factors Leading to Harm in English General Practices: A Mixed-Methods Study Based on Patient Experiences Integrating Structural Equation Modeling and Qualitative Content Analysis.

    Ricci-Cabello, Ignacio / Gangannagaripalli, Jaheeda / Mounce, Luke T A / Valderas, Jose María

    Journal of patient safety

    2020  Volume 17, Issue 1, Page(s) e20–e27

    Abstract: Objective: The aim of the study was to identify the main factors leading to harm in primary care based on the experiences reported by patients.: Methods: We conducted a mixed-methods, cross-sectional study in 45 primary care centers in England. A ... ...

    Abstract Objective: The aim of the study was to identify the main factors leading to harm in primary care based on the experiences reported by patients.
    Methods: We conducted a mixed-methods, cross-sectional study in 45 primary care centers in England. A random sample of 6736 patients was invited to complete the Patient-Reported Experiences and Outcomes of Safety in Primary Care questionnaire. We fitted structural equation modeling on the quantitative data (n = 1244 respondents) to identify contributory factors and primary incidents leading to harm. We conducted content analyses of responses to seven open-ended questions (n = 386) to obtain deeper insight into patient perceptions of the causes of harm experienced. Results from quantitative and qualitative analyses were triangulated.
    Results: Patients reported harm related to physical health (13%), pain (11%), and mental health (19%) and harm that increased limitations in social activities (14%). Physical harm was associated with incidents affecting diagnosis (β = 0.43; delayed and wrong), and treatment (0.12; delayed, wrong treatment, or dose), which were in turn associated with incidents with patient-provider communication, coordination between providers, appointments, and laboratory tests. Pain was associated with laboratory tests (0.21; caused when collecting blood or tissue samples) and with problems booking an appointment when needed (0.13; delaying treatment for pain). Harm to mental health was associated with incidents related to the following: diagnosis (0.28), patient-provider communication (0.18), appointments (0.17), coordination between different providers (0.14), and laboratory tests (0.12). Harm increasing limitations in social activities was associated with incidents related to diagnosis (0.42) and diagnostic and monitoring procedures (0.20).
    Conclusions: Our findings suggest the need for patient-centered strategies to reduce harm in primary care focusing on the improvement of the quality of diagnosis and patient-provider communication.
    MeSH term(s) Adult ; Cross-Sectional Studies ; England ; Female ; General Practice/methods ; Humans ; Male ; Patient Outcome Assessment ; Primary Health Care ; Qualitative Research
    Language English
    Publishing date 2020-02-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2394324-5
    ISSN 1549-8425 ; 1549-8417
    ISSN (online) 1549-8425
    ISSN 1549-8417
    DOI 10.1097/PTS.0000000000000669
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  4. Article ; Online: Integrating Patient Reported Outcome Measures (PROMs) into routine nurse-led primary care for patients with multimorbidity: a feasibility and acceptability study.

    Porter, Ian / Davey, Antoinette / Gangannagaripalli, Jaheeda / Evans, Jonathan / Bramwell, Charlotte / Evans, Philip / Gibbons, Chris / Valderas, Jose M

    Health and quality of life outcomes

    2021  Volume 19, Issue 1, Page(s) 133

    Abstract: Background: The use of Patient Reported Outcome Measures (PROMS) in clinical practice has the potential to promote patient-centred care and improve patients' quality of life. Individualized PROMs may be particularly helpful in identifying, prioritizing ... ...

    Abstract Background: The use of Patient Reported Outcome Measures (PROMS) in clinical practice has the potential to promote patient-centred care and improve patients' quality of life. Individualized PROMs may be particularly helpful in identifying, prioritizing and monitoring health problems of patients with multimorbidity. We aimed to develop an intervention centred around PROMs feedback as part of Primary Care annual reviews for patients with multimorbidity and evaluate its feasibility and acceptability.
    Methods: We developed a nurse-oriented intervention including (a) training of nurses on PROMs; (b) administration to patients with multimorbidity of individualized and standardized PROMS; and (c) feedback to both patients and nurses of PROMs scores and interpretation guidance. We then tailored the intervention to patients with two or more highly prevalent conditions (asthma, COPD, diabetes, heart failure, depression, and hip/knee osteoarthritis) and designed a non-controlled feasibility and acceptability evaluation in a convenience sample of primary care practices (5). PROMs were administered and scores fed back immediately ahead of scheduled annual reviews with nurses. Patients and nurses rated the acceptability of the intervention using with a brief survey including optional free comments. Thematic analysis of qualitative interviews with a sample of participating patients (10) and nurses (4) and of survey free comments was conducted for further in-depth evaluation of acceptability. Feasibility was estimated based on rates of participation and completion.
    Results: Out of 68 recruited patients (mean age 70; 47% female), 68 completed the PROMs (100%), received feedback (100%) and confirmed nurse awareness of their scores (100%). Most patients (83%) "agreed"/"strongly agreed" that the PROMs feedback had been useful, a view supported by nurses in 89% of reviews. Thematic analysis of rich qualitative data on PROMS administration, feedback and role in annual reviews indicated that both patients and nurses perceived the intervention as acceptable and promising, emphasizing its comprehensiveness and patient-centredness.
    Conclusions: We have developed and tested an intervention focusing on routine PROM assessment of patients with multimorbidity in Primary Care. Preliminary findings support its feasibility and a high degree of acceptability from both patients and nurses. The next step is to conduct a full-scale trial for evaluating the effectiveness of the proposed intervention.
    MeSH term(s) Aged ; Feasibility Studies ; Female ; Humans ; Male ; Multimorbidity ; Patient Reported Outcome Measures ; Patient-Centered Care/organization & administration ; Practice Patterns, Nurses' ; Primary Health Care/organization & administration ; Qualitative Research ; Quality of Life
    Language English
    Publishing date 2021-04-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2098765-1
    ISSN 1477-7525 ; 1477-7525
    ISSN (online) 1477-7525
    ISSN 1477-7525
    DOI 10.1186/s12955-021-01748-2
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  5. Article ; Online: Integrating Patient Reported Outcome Measures (PROMs) into routine nurse-led primary care for patients with multimorbidity

    Ian Porter / Antoinette Davey / Jaheeda Gangannagaripalli / Jonathan Evans / Charlotte Bramwell / Philip Evans / Chris Gibbons / Jose M. Valderas

    Health and Quality of Life Outcomes, Vol 19, Iss 1, Pp 1-

    a feasibility and acceptability study

    2021  Volume 19

    Abstract: Abstract Background The use of Patient Reported Outcome Measures (PROMS) in clinical practice has the potential to promote patient-centred care and improve patients’ quality of life. Individualized PROMs may be particularly helpful in identifying, ... ...

    Abstract Abstract Background The use of Patient Reported Outcome Measures (PROMS) in clinical practice has the potential to promote patient-centred care and improve patients’ quality of life. Individualized PROMs may be particularly helpful in identifying, prioritizing and monitoring health problems of patients with multimorbidity. We aimed to develop an intervention centred around PROMs feedback as part of Primary Care annual reviews for patients with multimorbidity and evaluate its feasibility and acceptability. Methods We developed a nurse-oriented intervention including (a) training of nurses on PROMs; (b) administration to patients with multimorbidity of individualized and standardized PROMS; and (c) feedback to both patients and nurses of PROMs scores and interpretation guidance. We then tailored the intervention to patients with two or more highly prevalent conditions (asthma, COPD, diabetes, heart failure, depression, and hip/knee osteoarthritis) and designed a non-controlled feasibility and acceptability evaluation in a convenience sample of primary care practices (5). PROMs were administered and scores fed back immediately ahead of scheduled annual reviews with nurses. Patients and nurses rated the acceptability of the intervention using with a brief survey including optional free comments. Thematic analysis of qualitative interviews with a sample of participating patients (10) and nurses (4) and of survey free comments was conducted for further in-depth evaluation of acceptability. Feasibility was estimated based on rates of participation and completion. Results Out of 68 recruited patients (mean age 70; 47% female), 68 completed the PROMs (100%), received feedback (100%) and confirmed nurse awareness of their scores (100%). Most patients (83%) “agreed”/”strongly agreed” that the PROMs feedback had been useful, a view supported by nurses in 89% of reviews. Thematic analysis of rich qualitative data on PROMS administration, feedback and role in annual reviews indicated that both patients and nurses perceived ...
    Keywords Primary health care ; Multimorbidity ; Patient-Reported Outcome Measures (PROMs) ; Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 610
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: Patient-centred outcomes in lateral elbow tendinopathy: A systematic review of available evidence in UK populations.

    Evans, Jonathan P / Smith, Chris / Porter, Ian / Gangannagaripalli, Jaheeda / Goodwin, Vicki / Valderas, Jose

    Shoulder & elbow

    2018  Volume 11, Issue 6, Page(s) 440–449

    Abstract: Background: For Patient-Reported Outcome Measures to be useful, they must have evidenced reliability, validity and responsiveness in both the condition and population of interest. The aim of this study is to systematically review the evidence for ... ...

    Abstract Background: For Patient-Reported Outcome Measures to be useful, they must have evidenced reliability, validity and responsiveness in both the condition and population of interest. The aim of this study is to systematically review the evidence for Patient-Reported Outcome Measures in UK patients with lateral elbow tendinopathy.
    Methods: A systematic search was performed in Ovid MEDLINE, Embase and CINAHL. Studies were included if reporting administration of Patient-Reported Outcome Measures in UK populations with lateral elbow tendinopathy. Patient-Reported Outcome Measures characteristics and target populations were assessed using a structured classification system. Patient-Reported Outcome Measures reporting in randomised controlled trials was assessed against Consolidated Standards of Reporting Trials (CONSORT) standards (Patient-Reported Outcome extension).
    Results: A total of 16 articles were included. Out of seven different Patient-Reported Outcome Measures, there was evidence of partial validation for five. The assessment of validity, reliability and responsiveness of all Patient-Reported Outcome Measures in lateral elbow tendinopathy UK populations extended to just 20 individual patients. No articles conformed to the CONSORT Patient-Reported Outcome extension standards.
    Conclusion: There exists a paucity of data on the psychometrics of Patient-Reported Outcome Measures in UK lateral elbow tendinopathy populations. Without these data, trial design and interpretation are significantly hindered. The high prevalence of this condition and significant volume of studies being conducted into novel treatments highlight the need for this knowledge gap to be resolved.
    Language English
    Publishing date 2018-08-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2503275-6
    ISSN 1758-5732
    ISSN 1758-5732
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  7. Article ; Online: STOPP/START interventions to improve medicines management for people aged 65 years and over

    Jaheeda Gangannagaripalli / Ian Porter / Antoinette Davey / Ignacio Ricci Cabello / Joanne Greenhalgh / Rob Anderson / Simon Briscoe / Carmel Hughes / Rupert Payne / Emma Cockcroft / Jim Harris / Charlotte Bramwell / Jose M Valderas

    Health Services and Delivery Research, Vol 9, Iss

    a realist synthesis

    2021  Volume 23

    Abstract: Background: Drug-related problems and potentially inappropriate prescribing impose a huge burden on patients and the health-care system. The most widely used tools for appropriate prescription in older adults in England and in other European countries ... ...

    Abstract Background: Drug-related problems and potentially inappropriate prescribing impose a huge burden on patients and the health-care system. The most widely used tools for appropriate prescription in older adults in England and in other European countries are the Screening Tool of Older People’s Prescriptions (STOPP)/Screening Tool to Alert to the Right Treatment (START) tools. STOPP/START tools support medicines optimisation for older adults. Objectives: To identify, test and refine the programme theories underlying how interventions based on the STOPP/START tools are intended to work, for whom, in what circumstances and why, as well as the resource use and cost requirements or impacts. Design: A realist synthesis. Setting: Primary care, hospital care and nursing homes. Patients: Patients aged ≥ 65 years. Interventions: Any intervention based on the use of the STOPP/START tools. Review methods: Database and web-searching was carried out to retrieve relevant evidence to identify and test programme theories about how interventions based on the use of the STOPP/START tools work. A project reference group made up of health-care professionals, NHS decision-makers, older people, carers and members of the public was set up. In phase 1 we identified programme theories about STOPP/START interventions on how, for whom, in what contexts and why they are intended to work. We searched the peer-reviewed and grey literature to identify documents relevant to the research questions. We interviewed experts in the field in our reference group to gain input on our list of candidate context–mechanism–outcome configurations, to identify additional context–mechanism–outcome configurations and to identify additional literature and/or relevant concepts. In phase 2 we reviewed and synthesised relevant published and unpublished empirical evidence and tested the programme theories using evidence from a larger set of empirical studies. Results: We developed a single logic model structured around three key mechanisms: (1) personalisation, (2) ...
    Keywords medication review ; medication reconciliation ; inappropriate medication ; older adults ; Public aspects of medicine ; RA1-1270 ; Medicine (General) ; R5-920
    Subject code 360
    Language English
    Publishing date 2021-11-01T00:00:00Z
    Publisher National Institute for Health Research
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Clinical rating systems in elbow research-a systematic review exploring trends and distributions of use.

    Evans, Jonathan P / Smith, Chris D / Fine, Nicola F / Porter, Ian / Gangannagaripalli, Jaheeda / Goodwin, Victoria A / Valderas, Jose M

    Journal of shoulder and elbow surgery

    2018  Volume 27, Issue 4, Page(s) e98–e106

    Abstract: Background: Clinical rating systems are used as outcome measures in clinical trials and attempt to gauge the patient's view of his or her own health. The choice of clinical rating system should be supported by its performance against established quality ...

    Abstract Background: Clinical rating systems are used as outcome measures in clinical trials and attempt to gauge the patient's view of his or her own health. The choice of clinical rating system should be supported by its performance against established quality standards.
    Methods: A search strategy was developed to identify all studies that reported the use of clinical rating systems in the elbow literature. The strategy was run from inception in Medline Embase and CINHAL. Data extraction identified the date of publication, country of data collection, pathology assessed, and the outcome measure used.
    Results: We identified 980 studies that reported clinical rating system use. Seventy-two separate rating systems were identified. Forty-one percent of studies used ≥2 separate measures. Overall, 54% of studies used the Mayo Elbow Performance Score (MEPS). For arthroplasty, 82% used MEPS, 17% used Disabilities of Arm, Shoulder and Hand (DASH), and 7% used QuickDASH. For trauma, 66.7% used MEPS, 32% used DASH, and 23% used the Morrey Score. For tendinopathy, 31% used DASH, 23% used Patient-Rated Tennis Elbow Evaluation (PRTEE), and 13% used MEPS. Over time, there was an increased proportional use of the MEPS, DASH, QuickDASH, PRTEE, and the Oxford Elbow Score.
    Conclusions: This study identified a wide choice and usage of clinical rating systems in the elbow literature. Numerous studies reported measures without a history of either a specific pathology or cross-cultural validation. Interpretability and comparison of outcomes is dependent on the unification of outcome measure choice. This was not demonstrated currently.
    MeSH term(s) Arthroplasty ; Elbow Joint/injuries ; Elbow Joint/physiopathology ; Elbow Joint/surgery ; Elbow Tendinopathy/physiopathology ; Humans ; Patient Outcome Assessment ; Surveys and Questionnaires ; Tendinopathy/physiopathology
    Language English
    Publishing date 2018-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1170782-3
    ISSN 1532-6500 ; 1058-2746
    ISSN (online) 1532-6500
    ISSN 1058-2746
    DOI 10.1016/j.jse.2017.12.027
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    Zs.A 3973: Show issues Location:
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  9. Article ; Online: Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice.

    Gibbons, Chris / Porter, Ian / Gonçalves-Bradley, Daniela C / Stoilov, Stanimir / Ricci-Cabello, Ignacio / Tsangaris, Elena / Gangannagaripalli, Jaheeda / Davey, Antoinette / Gibbons, Elizabeth J / Kotzeva, Anna / Evans, Jonathan / van der Wees, Philip J / Kontopantelis, Evangelos / Greenhalgh, Joanne / Bower, Peter / Alonso, Jordi / Valderas, Jose M

    The Cochrane database of systematic reviews

    2021  Volume 10, Page(s) CD011589

    Abstract: Background: Patient-reported outcomes measures (PROMs) assess a patient's subjective appraisal of health outcomes from their own perspective. Despite hypothesised benefits that feedback  on PROMs can support decision-making in clinical practice and ... ...

    Abstract Background: Patient-reported outcomes measures (PROMs) assess a patient's subjective appraisal of health outcomes from their own perspective. Despite hypothesised benefits that feedback  on PROMs can support decision-making in clinical practice and improve outcomes, there is uncertainty surrounding the effectiveness of PROMs feedback.
    Objectives: To assess the effects of PROMs feedback to patients, or healthcare workers, or both on patient-reported health outcomes and processes of care.
    Search methods: We searched MEDLINE, Embase, CENTRAL, two other databases and two clinical trial registries on 5 October 2020. We searched grey literature and consulted experts in the field.
    Selection criteria: Two review authors independently screened and selected studies for inclusion. We included randomised trials directly comparing the effects on outcomes and processes of care of PROMs feedback to healthcare professionals and patients, or both with the impact of not providing such information.
    Data collection and analysis: Two groups of two authors independently extracted data from the included studies and evaluated study quality. We followed standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the evidence. We conducted meta-analyses of the results where possible.
    Main results: We identified 116 randomised trials which assessed the effectiveness of PROMs feedback in improving processes or outcomes of care, or both in a broad range of disciplines including psychiatry, primary care, and oncology. Studies were conducted across diverse ambulatory primary and secondary care settings in North America, Europe and Australasia. A total of 49,785 patients were included across all the studies. The certainty of the evidence varied between very low and moderate. Many of the studies included in the review were at risk of performance and detection bias. The evidence suggests moderate certainty that PROMs feedback probably improves quality of life (standardised mean difference (SMD) 0.15, 95% confidence interval (CI) 0.05 to 0.26; 11 studies; 2687 participants), and leads to an increase in patient-physician communication (SMD 0.36, 95% CI 0.21 to 0.52; 5 studies; 658 participants), diagnosis and notation (risk ratio (RR) 1.73, 95% CI 1.44 to 2.08; 21 studies; 7223 participants), and disease control (RR 1.25, 95% CI 1.10 to 1.41; 14 studies; 2806 participants). The intervention probably makes little or no difference for general health perceptions (SMD 0.04, 95% CI -0.17 to 0.24; 2 studies, 552 participants; low-certainty evidence), social functioning (SMD 0.02, 95% CI -0.06 to 0.09; 15 studies; 2632 participants; moderate-certainty evidence), and pain (SMD 0.00, 95% CI -0.09 to 0.08; 9 studies; 2386 participants; moderate-certainty evidence). We are uncertain about the effect of PROMs feedback on physical functioning (14 studies; 2788 participants) and mental functioning (34 studies; 7782 participants), as well as fatigue (4 studies; 741 participants), as the certainty of the evidence was very low. We did not find studies reporting on adverse effects defined as distress following or related to PROM completion.
    Authors' conclusions: PROM feedback probably produces moderate improvements in communication between healthcare professionals and patients as well as in diagnosis and notation, and disease control, and small improvements to quality of life. Our confidence in the effects is limited by the risk of bias, heterogeneity and small number of trials conducted to assess outcomes of interest. It is unclear whether   many of these improvements are clinically meaningful or sustainable in the long term. There is a need for more high-quality studies in this area, particularly studies which employ cluster designs and utilise techniques to maintain allocation concealment.
    MeSH term(s) Feedback ; Health Personnel ; Humans ; Patient Reported Outcome Measures ; Primary Health Care ; Quality of Life
    Language English
    Publishing date 2021-10-12
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
    ISSN 1469-493X
    ISSN (online) 1469-493X
    DOI 10.1002/14651858.CD011589.pub2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Assessing Patient-Centred Outcomes in Lateral Elbow Tendinopathy: A Systematic Review and Standardised Comparison of English Language Clinical Rating Systems.

    Evans, Jonathan Peter / Porter, Ian / Gangannagaripalli, Jaheeda B / Bramwell, Charlotte / Davey, Antoinette / Smith, Chris D / Fine, Nicola / Goodwin, Victoria A / Valderas, Jose M

    Sports medicine - open

    2019  Volume 5, Issue 1, Page(s) 10

    Abstract: Background: Lateral elbow tendinopathy (LET) is a common condition affecting adults. Although a lack of treatment consensus continues to prompt numerous effectiveness studies, there is a paucity of clear guidance on the choice of outcome measure. Our ... ...

    Abstract Background: Lateral elbow tendinopathy (LET) is a common condition affecting adults. Although a lack of treatment consensus continues to prompt numerous effectiveness studies, there is a paucity of clear guidance on the choice of outcome measure. Our aim was to undertake a standardised evaluation of the available clinical rating systems that report patient-centred outcomes in LET.
    Methods: A systematic review of studies reporting the development, assessment of metric properties and/or use of instruments aiming to quantify LET-specific patient-centred outcome measures was conducted in MEDLINE, Embase and CINAHL (inception-2017) adhering to PRISMA guidance. The evidence for each instrument was independently assessed by two reviewers using the standardised evaluating measures of patient-reported outcomes (EMPRO) method evaluating overall and attribute-specific instrument performance (metric properties and usability). EMPRO scores > 50/100 were considered indicative of high performance.
    Results: Out of 7261 references, we identified 105 articles reporting on 15 instruments for EMPRO analysis. Median performance score was 41.6 (range 21.6-72.5), with four instruments meeting high-performance criteria: quick Disabilities of the Arm Shoulder and Hand score (qDASH) (72.5), DASH (66.9), Oxford Elbow Score (OES) (66.6) and Patient-Rated Tennis Elbow Evaluation (PRTEE) (57.0). One hundred seventy-nine articles reported instrument use internationally with DASH as the most frequent (29.7% articles) followed by PRTEE (25.6%), MEPS (15.1%) and qDASH (8.1%). The correlation between frequency of use and performance was r = 0.35 (95%CI - 0.11; 0.83).
    Conclusions: This is the first study to provide standardised guidance on the choice of measures for LET. A large number of clinical rating systems are both available and being used for patients with LETs. Robust evidence is available for four measures, the DASH, QDASH, PRTEE and OES. The use of instruments in the literature is only in part explained by instrument performance.
    Language English
    Publishing date 2019-03-20
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2809942-4
    ISSN 2198-9761 ; 2199-1170
    ISSN (online) 2198-9761
    ISSN 2199-1170
    DOI 10.1186/s40798-019-0183-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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