What Do U.K. Orthopedic Surgery Patients Think About PROMs? Evaluating the Evaluation and Explaining Missing Data

Area of Science:

• Health Services Research
• Orthopedic Surgery Outcomes
• Patient-Reported Outcome Measures

Background:

• The NHS uses patient-reported outcome measures (PROMs) to assess quality of life after hip or knee replacement.
• Low completion rates (as low as 30%) limit the usefulness of national PROMs data.
• Statistical analysis alone cannot fully explain missing data.

Purpose of the Study:

• To qualitatively explore barriers and facilitators to completing preoperative PROMs.
• To identify practical improvements for enhancing PROMs completion rates in orthopedic settings.

Main Methods:

• Qualitative study involving observations and semistructured interviews with 34 preoperative orthopedic patients.
• Thematic analysis of interview data, triangulated with observational findings.
• Exploration of themes including completion timing, patient support, and delivery methods.

Main Results:

• Key themes identified: completion conditions, patient support needs, and national delivery processes.
• Pragmatic barriers and facilitators significantly impact PROMs completion.
• Simple interventions like designated quiet zones and improved preoperative information distribution were highlighted.

Conclusions:

• Implementing minor improvements can significantly increase PROMs completion rates and data quality.
• Revising preoperative information and distribution can enhance patient acceptance and reduce staff workload.
• Findings suggest a need for further discussion regarding mandatory preoperative PROMs.