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Multicenter Study
. 2025 Jan 8;23(1):4.
doi: 10.1186/s12955-024-02327-x.

Development of a PROM to measure patient-centredness in chronic care consultations in primary care

Anne Holm #  1 , Anna Bernhardt Lyhnebeck #  2 , Sussi Friis Buhl  3 , Kristine Bissenbakker  2 , Jette Kolding Kristensen  4 , Anne Møller  2   5 , Anders Prior  6 , Zaza Kamper-Jørgensen  2 , Sidsel Böcher  2 , Mads Aage Toft Kristensen  2   5 , Asger Waagepetersen  2 , Anders Hye Dalsgaard  2 , Volkert Siersma  2 , Ann Dorrit Guassora  2 , John Brandt Brodersen  2   7   8 ; on behalf MM600 trial group
Collaborators, Affiliations
Multicenter Study

Development of a PROM to measure patient-centredness in chronic care consultations in primary care

Anne Holm et al. Health Qual Life Outcomes. .

Abstract

Introduction: Validated patient-reported outcome measures (PROMs) are crucial for assessing patients' experiences in the healthcare system. Both clinically and theoretically, patient-centered consultations are essential in patient-care, and are often suggested as the optimal strategy in caring for patients with multimorbidity.

Aim: To either identify or develop and validate a patient-reported outcome measure (PROM) to assess patient-centredness in consultations for patients with multimorbidity in general practice.

Methods: We attempted to identify an existing PROM through a systematic literature review. If a suitable PROM was not identified, we planned to (1) construct a draft PROM based on items from existing PROMs, (2) conduct group and individual interviews among members of the target population to ensure comprehensibility, comprehensiveness and relevance, and (3) perform a psychometric validation in a broad sample of patients from primary care.

Results: We did not identify an eligible PROM in the literature review. The item extraction and face validity meetings resulted in a new PROM consisting of 47 items divided into five domains: biopsychosocial perspective; `patient-as-person'; sharing power and responsibility; therapeutic alliance; and coordinated care. The interviews resulted in a number of changes to the layout and phrasing as well as the deletion of items. The PROM used in the psychometric validation consisted of 28 items. Psychometric validation showed high internal consistency, overall high reliability, and moderate fit indices in the confirmatory factor analysis for all five domains. Few items demonstrated differential item functioning concerning variables such as age, sex, and education.

Conclusions: This study successfully developed and validated a PROM to measure patient-centredness in consultations for patients with multimorbidity. The five domains demonstrated high reliability and validity, making it a valuable tool for measuring patient-centredness of consultations in general practice.

Trial registration: Trial registration number (data for psychometric validation): https://clinicaltrials.gov : NCT05676541 Registration Date: 2022-12-16.

Keywords: Chronic disease; General practice; Multimorbidity; Patient-centredness; Patient-reported outcome measures; Primary care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the protocol and the Helsinki Declaration in its most recent form. Good clinical practice guidelines was followed as well as rules for informed consent. According to Sect. 2 of the Danish Act on Research Ethics of Research Projects, this project does not constitute a health research project but is rather considered a quality improvement project. The protocols for the studies included in this manuscript was presented to Denmark’s Capital Region’s Ethical Committee for confirmation (ref: H- 22041229). All patients gave informed consent for the interviews and before completing the questionnaire. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The steps in the development and validation of the PROM
Fig. 2
Fig. 2
Content validation procedure visualized. PROM: patient-reported outcome measure
Fig. 3
Fig. 3
Differential Item Functioning (DIF) analysis for each of the five domains
See this image and copyright information in PMC

References

    1. Feinstein AR. The pre-therapeutic classification of co-morbidity in chronic disease. J Chronic Dis. 1970;23(7):455–68. - PubMed
    1. Harrison C, Fortin M, van den Akker M, Mair F, Calderon-Larranaga A, Boland F, et al. Comorbidity versus multimorbidity: why it matters. J Multimorbidity Comorbidity. 2021;11:263355652199399. - PMC - PubMed
    1. Baker M. Responding to the needs of patients with multimorbidity. A vision for general practice. Royal College of General Practitioners; 2016.
    1. Mercer SW, Fitzpatrick B, Gourlay G, Vojt G, McConnachie A, Watt GCM. More time for complex consultations in a high-deprivation practice is associated with increased patient enablement. Br J Gen Pract. 2007;57(545):960–6. - PMC - PubMed
    1. Stumm J, Thierbach C, Peter L, Schnitzer S, Dini L, Heintze C, et al. Coordination of care for multimorbid patients from the perspective of general practitioners - a qualitative study. BMC Fam Pract. 2019;20(1):1–11. - PMC - PubMed

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