Understanding Patient-Reported Outcome Measures (PROMs)
What are PROMs?
Patient-Reported Outcome Measures (PROMs) are standardised tools usually in the form of validated questionnaires used to understand a patient’s own perspective on their health, wellbeing and quality of life. Rather than relying solely on clinical tests or practitioner observations, PROMs capture information directly from patients about their symptoms, daily functioning, mental health, and overall quality of life.
PROMs provide valuable insight into how patients experience their condition and the impact of healthcare interventions over time.
Why PROMs Matter
PROMs play an essential role in modern healthcare because they:
-
Focus on the patient’s experience, not just clinical outcomes.
-
Track changes in health status before, during and after treatment.
-
Provide data to enhance quality and safety in healthcare delivery.
-
Support value-based care, which prioritises improving outcomes that matter most to patients.
-
Enable benchmarking, allowing providers to compare results and identify best practice.
Types of PROMs
PROMs can be grouped into two main categories:
- Generic PROMs
These can be used across a wide range of conditions and populations. They provide a broad measure of health-related quality of life, such as physical function, emotional wellbeing and social participation.
Examples: EQ-5D, SF-36, PROMIS.
- Condition-Specific PROMs
These focus on particular health problems or body regions and are designed to detect subtle but important changes in those specific conditions.
Examples: Oswestry Disability Index (for back pain), Neck Disability Index, Bournemouth Questionnaire.
How PROMs Are Used
PROMs can be applied at several levels within healthcare:
Clinical Level
Help clinicians and patients discuss symptoms, treatment goals and progress.
Support shared decision-making by providing objective feedback on patient experience.
Professional or Organisational Level
Aggregated PROM data allow for comparison between practitioners or services, highlighting areas for improvement or best performance.
System and Policy Level
PROMs data can inform public health policy, evaluate service performance and contribute to value-based funding models.
Examples of Common PROM Tools
- Pain Measures: Visual Analogue Scale (VAS), Numeric Rating Scale (NRS).
- Disability Measures: Roland-Morris Disability Questionnaire, Oswestry Disability Index, Neck Disability Index.
- Psychosocial Measures: Keele STarT Back Tool, Fear-Avoidance Beliefs Questionnaire (FABQ).
- Quality of Life Measures: EQ-5D, SF-36, PROMIS-29.
- Mental Health Measures: Depression Anxiety and Stress Scale (DASS), Generalised Anxiety Disorder Questionnaire (GAD-7), Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI).
- Patient Satisfaction and Self-Perceived Health: Visit-Specific Satisfaction Questionnaire (VSQ-9), Measure Yourself Medical Outcome Profile (MYMOP2).
The Value of PROMs in Healthcare
Implementing PROMs benefits both patients and clinicians by:
- Promoting patient-centred communication and collaborative decision-making.
- Helping practitioners assess treatment effectiveness objectively.
- Driving quality improvement through ongoing monitoring and benchmarking.
- Supporting safety initiatives by identifying trends or issues early.
- Encouraging value-based care, where healthcare delivery is judged on outcomes rather than volume.
Finding and Selecting PROMs
To identify appropriate PROMs for a given condition or context:
- Review academic literature and clinical guidelines.
- Use established repositories such as the Rehabilitation Measures Database (https://www.sralab.org/rehabilitation-measures), which contains hundreds of validated tools.
- Choose PROMs that are reliable, valid, easy to administer, and appropriate for the target patient population.
