PREMs: Capturing the Patient Journey in Healthcare Research

Introduction

In the ever-evolving landscape of healthcare research, a new player has emerged alongside the now-familiar Patient Reported Outcome Measures (PROMs). Enter Patient Reported Experience Measures, or PREMs – tools designed to capture the nuances of a patient’s healthcare journey. As we delve into the world of PREMs, we’ll explore their unique role, how they complement PROMs, and their potential to transform healthcare delivery and research.

Understanding PREMs

Patient Reported Experience Measures are standardised, validated tools that capture patients’ perceptions of their experience whilst receiving care. Unlike PROMs, which focus on health outcomes, PREMs shine a light on the care process itself. They might ask about the clarity of information provided, the friendliness of staff, the cleanliness of facilities, or the degree to which patients felt involved in decision-making about their care.

PREMs typically cover aspects such as:

Communication with healthcare providers
Access to care
Physical comfort
Emotional support
Respect for patient preferences
Continuity and coordination of care

These measures provide invaluable insights into the quality of healthcare services from the patient’s perspective, offering a view that traditional clinical measures often miss.

PREMs vs PROMs: Two Sides of the Same Coin

While PREMs and PROMs might seem similar at first glance, they serve distinct yet complementary purposes. PROMs focus on the outcomes of care – how a patient’s health status or quality of life has changed. PREMs, on the other hand, zero in on the experience of receiving that care.

Think of it this way: if a PROM asks, “How much has your pain improved?”, a PREM might ask, “Did you feel your concerns about pain were taken seriously?” Both questions are crucial, but they provide different types of information.

There are scenarios where one might be more appropriate than the other. If you’re evaluating the effectiveness of a new treatment, PROMs might be your go-to. But if you’re assessing patient satisfaction with a new clinic layout, PREMs would be more suitable. Often, using both in tandem provides the most comprehensive picture of healthcare quality.

The Importance of PREMs in Healthcare

PREMs have become increasingly vital in healthcare for several reasons. Firstly, they acknowledge that the patient experience is a crucial aspect of healthcare quality. A positive experience can lead to better adherence to treatment plans, improved health outcomes, and increased patient satisfaction.

Secondly, PREMs provide actionable data for healthcare providers and institutions. If patients consistently report poor experiences in a particular area, it highlights a clear opportunity for improvement.

Thirdly, in an era of patient-centred care, PREMs give patients a voice in shaping healthcare services. They empower patients to contribute to the ongoing evolution of healthcare delivery.

Finally, PREMs can be powerful tools for benchmarking and quality improvement. By comparing PREM data across different healthcare providers or over time, researchers and policymakers can identify best practices and areas needing attention.

Implementing PREMs Effectively

To harness the full potential of PREMs, consider the following:

Choose appropriate measures: Select PREMs that are validated, relevant to your specific healthcare context, and aligned with your research or quality improvement goals.
Time it right: Administer PREMs at suitable points in the patient journey. Immediately after a healthcare encounter can capture fresh experiences, while a delay might allow for reflection.
Ensure accessibility: Make PREMs available in formats that are easy for all patients to understand and complete, considering factors like language, literacy levels, and digital access.
Combine with other data: Integrate PREM data with clinical outcomes and PROM data for a holistic view of healthcare quality.
Act on the results: Use PREM data to drive tangible improvements in healthcare delivery. This not only enhances care but also encourages future patient participation.

PREMs in Women’s Health Research

In women’s health research, particularly in areas like urinary and pelvic health, PREMs can play a crucial role. These conditions often involve sensitive, long-term care journeys where the quality of patient-provider interactions can significantly impact outcomes.

PREMs can help researchers understand how women experience care for these conditions. Do they feel listened to? Are their concerns taken seriously? Do they receive clear information about their treatment options? These insights can guide the development of more patient-centred care models and potentially improve treatment adherence and outcomes.

Moreover, PREMs can highlight any disparities in care experiences among different groups of women, helping to address issues of equity in healthcare delivery.

Conclusion

As we continue to strive for truly patient-centred healthcare, PREMs emerge as invaluable tools in our research arsenal. They complement the insights gained from PROMs, providing a more complete picture of healthcare quality that encompasses both outcomes and experiences.

While organisations like PARED Insights currently focus on PROMs, the principles of patient-centred research they champion align closely with the ethos behind PREMs. As the field evolves, integrating both PROMs and PREMs may become the gold standard in patient-centred healthcare research.

In the end, PREMs remind us that healthcare is not just about treating conditions, but about caring for people. By capturing and acting on patient experiences, we can create a healthcare system that not only heals, but also listens, respects, and continually improves. And that’s an experience worth measuring.