Patient education on PROM completion in clinical care settings: a scoping review

Background Patient-reported outcome measures (PROMs) are increasingly used in clinical care, and evidence demonstrates they enhance patient care processes and outcomes. However, low PROM completion rates can hinder their use for patient-level monitoring and clinical decision-making. Patient education may help overcome barriers to PROM completion, yet little is known about what education, if any, is offered. The aim of this scoping review was to understand if and how education on PROMs is provided to patients in clinical care.

Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. MEDLINE, Embase, and APA PsychINFO were searched. Eligible studies used PROMs for individual patient care where PROM results are discussed with the patient, and described patient education on PROMs. Articles were double-screened, data was extracted and relevant data items were categorized and reported.

Results In total 4392 titles and abstracts were screened, and 292 full texts were reviewed. Only 75 studies were included because they mentioned or described patient education on PROMs. Education was often provided by clinical staff or research staff, using verbal, written or multimodal methods. Education typically occurred prior to PROM completion, and sometimes during PROM completion. The review identified five key components describing the content of education: (1) introduction to PROMs, (2) explanation of their purpose, (3) method of completing PROMs, (4) presentation and (5) utilization of PROM results. These components are presented as the PROMs Patient Education Model. Most studies described to educate on the method of PROM completion, followed by the purpose of PROMs in clinical care. Only a few studies examined patient experiences with education or assessed the impact of education on PROM completion. Despite positive indications, due to the limited number and nature of the included studies, no conclusions on the effect of patient education on PROM completion rates can be made.

Conclusions While patients may be educated about PROMs in clinical care, it is premature to consider patient education as standard in PROM implementation. This might partly be explained by the lack of detailed reporting in the literature. A survey with healthcare stakeholders could clarify current practices. The effect of patient education on PROM completion remains unclear, and it is recommended that future PROM studies measure the impact of education and report it in literature.