Abstract
Objective
This systematic review examines the facilitators and barriers to the use of patient-reported
outcome measures (PROMs) in outpatient rehabilitation settings and provides strategies
to improve care to maximize patient outcomes.
Data Sources
Eleven databases were systematically searched from November 2018 to May 2019.
Study Selection
Two reviewers independently assessed articles based on the following inclusion criteria:
English text, evaluate barriers and facilitators, include PROMs, and occur in an outpatient
rehabilitation setting (physical therapy, occupational therapy, speech language pathology,
or athletic training). Of the 10,164 articles initially screened, 15 articles were
included in this study.
Data Extraction
Data were extracted from the selected articles by 2 independent reviewers and put
into an extraction template and into the Consolidated Framework for Implementation
Research (CFIR) model. The Appraisal Tool for Cross-Sectional Studies (AXIS) was conducted
on each study to assess study design, risk of bias, and reporting quality of the eligible
studies.
Data Synthesis
Ten studies were identified as high quality, according to the AXIS. Based on the CFIR
model, the top barriers identified focused on clinician training and time in the implementation
process, lack of recognized value and knowledge at the individual level, lack of access
and support in the inner setting, and inability of patients to complete PROMs in the
intervention process. Facilitators were identified as education in the implementation
process, support and availability of PROMs in the inner setting, and recognized value
at the individual level.
Conclusions
More barriers than facilitators have been identified, which is consistent with PROM
underuse. Clinicians and administrators should find opportunities to overcome the
barriers identified and leverage the facilitators to improve routine PROM use and
maximize patient outcomes.
Keywords
List of abbreviations:
AT (athletic training), AXIS (Appraisal Tool for Cross-Sectional Studies), CFIR (Consolidated Framework for Implementation Research), OT (occupational therapy), PROM (patient-reported outcome measure), PT (physical therapy), SLP (speech language pathology)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 13, 2020
Footnotes
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine