The objective of this study was to evaluate the HRQoL domains currently assessed by HCPs in chronic pain programs and the type of clinical outcomes used to assess these domains. These findings will inform the gaps in HRQoL domains and standardized clinical outcomes used to measure these domains, with a focus on PROMs.
Abstract
Purpose
To evaluate the health-related quality of life (HRQoL) domains currently assessed by healthcare professionals (HCPs) in secondary and tertiary hospital-based chronic pain clinics and the type of clinical outcomes (CO) used.
Methods
Electronic cross-sectional survey (May to September 2016) based on domains of HRQoL included in the Patient-Reported Outcomes Measurement Information System (PROMIS) framework.
Results
HCPs response rate was 53% (36/68). Their mean clinical experience was 14.8 years (± 11.1), and their mean experience treating chronic pain (CP) population was 10.2 years (± 7.8). All PROMIS-HRQoL domains were assessed by HCPs (range 28–97%, mean = 64%) with a preponderance of domains related to physical health (mean = 82%). Standardized outcome measures (OMs) including performance outcomes and patient-reported outcomes (PROs) were not frequently used (mean 0.5% and 3%, respectively) for assessing HRQoL domains compared to clinician reported outcomes (patient interviews, patient observation) (mean = 87%). Forty different OMs for assessing HRQoL domains were reported, and 30% of OMs were used by more than one HCP. HCPs expressed a need (range from 2.3 to 26.3%) for using more than one type of CO for assessing most domains of HRQoL (range from 2.3 to 26.3%) with a preference of using more PROs combined with CROs.
Conclusions
All domains of HRQoL are assessed by at least some HCPs for chronic pain management. Standardized OMs including performance-based measures and PROs were not frequently used, and there was no consistent use of the same OM across HCPs. A consensus among different stakeholders in chronic pain management on core domains of HRQoL and their associated OMs to promote a more evidence-based assessment is needed.
Zidarov, D., Visca, R., & Ahmed, S. (2019). Type of clinical outcomes used by healthcare professionals to evaluate health-related quality of life domains to inform clinical decision making for chronic pain management. Quality of Life Research, 28(10), 2761-2771.