Respondent fatigue in clinical practice: exploring the challenges of increasing PROMS and PREMS utilization in a...

The growing adoption of patient-reported measures (PRMs) in routine clinical practice has raised concerns about 'respondent fatigue', which leads patients to not complete questionnaires. Respondent fatigue poses risks not only for patient follow-up but also for data quality and overall experience. The aim is to evaluate the frequency of patients receiving PRMs potentially leading to respondent fatigue, considering both patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) in a tertiary Spanish hospital. Based on all questionnaires sent to patients in 2022, we quantified risk-inducing situations that could influence respondent fatigue in routine clinical practice.

The analysis included all adult patients attending the hospital in 2022. Information systems data were used to estimate the frequency of patient visits across various healthcare settings. The analysis assessed the frequency of annual multiple encounters, involving a selected set of 8 clinical conditions and 2 programs, mirroring real-world uses of PREMs and PROMs in both inpatient and outpatient care. By integrating both datasets, we evaluated the probability of co-occurrence and potential overlap between clinical conditions and/or healthcare settings requiring the administration of patient reported measures.

This study revealed a significantly high frequency of patient contacts for PRM collection, totalling 322,039 interactions in 2022, with an average of 2.81 contacts per year per PRMs collection. Among nearly 50,000 patients with four or more healthcare interactions, the average number of PRM collection contacts reached 8,03. For selected programs involving PROM collection, 25,016 patients enrolled in a single program had an average of 2.49 contacts per year, while 4,068 and 519 patients enrolled in two or more than three programs experienced averages of 4.46 and 6.52 contacts, respectively. These results highlight the burden of frequent PRM collection and the associated risk of respondent fatigue. These findings emphasize the cumulative burden of PRM collection and highlight the associated risk of respondent fatigue.

These results emphasize the challenges posed by the frequency and integration of PRMs in usual clinical practice in healthcare settings, urging strategies to improve patient experience and prevent data quality loss/reduce respondent fatigue.