UK Validation of the First Vascular Surgery Patient Reported Experience Measure (PREM): The PREMIERE Study

The aim of this study was to psychometrically validate a vascular surgery specific Patient Reported Experience Measure (PREM).

The PREM was developed through a multiphase process involving systematic review, qualitative multicentre validation study within a multiphase instrument development programme, patient interviews, and healthcare professional focus groups. The present study reports its validation across three UK vascular units. Psychometric evaluation followed COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance, assessing item reduction, factor structure, internal consistency (Cronbach's α), construct validity, feasibility, and acceptability.

Two hundred and forty patients completed the PREM (mean age 69.1 years; 61.3% men). The 22 item instrument was reduced to 14 items following psychometric evaluation. Feasibility was high, with > 95% item completion for 12 of 14 items, mean completion time of seven minutes, and 82.1% of questionnaires completed independently. Exploratory factor analysis supported a five domain structure, explaining 58.6% of the variance: information and communication, shared decision making, access and timeliness, inpatient support and overall experience, and discharge and follow up. Internal consistency was acceptable across domains (α = 0.70 - 0.78) and for the overall scale (α = 0.71). PREM scores were lower with longer hospital stay (r = -0.36, p < .001) and emergency admission (r = -0.15, p = .032), and higher with increasing time since discharge (r = .14, p = .041). Key predictors of overall satisfaction included communication, staff availability, timeliness, pain management information, and emotional support.

This vascular specific PREM is a concise, reliable, and valid instrument, feasible for routine use and sensitive to clinically meaningful variation, supporting patient centred evaluation of vascular services.