title: Moving from PROMs to POEMs for glaucoma care: a qualitative scoping exercise.
abstract: OBJECTIVE
  Patient-reported outcome measures (PROMs) are accepted widely as important outcomes in comparative effectiveness research. Over 30 PROMs have been described for use in glaucoma research, but their role in routine care is undefined. Our study explores the views of patients with glaucoma and their carers on the feasibility and content of a glaucoma PROM for use in day-to-day clinical practice.
  
  
  METHODS
  Focus groups were held with 71 participants facilitated by 23 staff working in the field of ophthalmology. Comparisons were made among themes derived from this exercise using simple thematic analysis and currently available health-related quality of life (HRQoL) instruments.
  
  
  RESULTS
  Participants were supportive of reporting their outcomes if the instrument was short, practical, and useful. Potential barriers to the use of PROMs, including bureaucratic overload and accessibility issues, were identified. Measuring health outcome and patient experience was important to participants. No freely available instrument covers all the domains identified, particularly knowledge and understanding. A novel instrument, a glaucoma patient-reported outcome and experience measure (POEM) is proposed. This addresses three aspects of outcome (fear of blindness, acceptability of treatment/side effects, and impact on daily life), and three aspects of experience (safety, respect, and understanding).
  
  
  CONCLUSIONS
  Using PROMs routinely in the management of glaucoma presents significant challenges. Although current instruments (questionnaires) cover many of the participants' key domains, no single instrument covered them all. Further research is required to determine the feasibility (resources required), and validity and reliability of the proposed glaucoma POEM in clinical care.
authors.affiliation: Vision & Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, United Kingdom. jsomner@googlemail.com
authors.forename: John E A
authors.initials: JE
authors.lastname: Somner
authors.forename: Freda
authors.initials: F
authors.lastname: Sii
authors.forename: Rupert R
authors.initials: RR
authors.lastname: Bourne
authors.forename: Vinette
authors.initials: V
authors.lastname: Cross
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Burr
authors.forename: Peter
authors.initials: P
authors.lastname: Shah
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D057186:Comparative Effectiveness Research / Q000379:methods; D005260:Female; D005901:Glaucoma / Q000523:psychology / Q000628:therapy*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D055815:Young Adult