title: Framework to assess the effects of using patient-reported outcome measures in chronic care management.
abstract: OBJECTIVE
  The inclusion of patient-reported outcome measures (PROMs) in the routine clinical care of chronically ill patients has the potential to add valuable information about the impact of the disease and its treatment and promotes effective patient self-management in which patients become more active participants in their own care. PROMs provide clinicians with timely information on patients' symptoms as well as functional and emotional status. PROMs are a useful tool for enhancing patient-clinician communication.
  
  
  METHODS
  We develop a conceptual framework describing the potential effects of the use of PROMs in chronic care management. The framework summarizes insights from the methods for evaluating the clinical effectiveness and methods for the health technology assessment of diagnostic technologies and results from the relevant studies.
  
  
  RESULTS
  The framework describes potential effects, from proximal to distal, including communication (patient-clinician, patient-relative, clinician-clinician, and clinician-relative), engaging patients in shared clinical decision making, patient management (clinician management and patient self-management), and patient outcomes. Important potential effects also include enhancement in patient activation as well as improvements in clinician and patient satisfaction, and patient adherence to recommended treatment. Previous frameworks have described patient-physician communication, patient satisfaction, and health outcomes. Our framework adds unique domains, including patient engagement, patient activation, shared clinical decision making, and patient self-management.
  
  
  CONCLUSIONS
  The framework can be used as a tool to guide the development of interventions to improve chronic care management through the use of PROMs.
authors: W21C Research and Innovation Centre, Faculty of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Canada, mjsantan@ucalgary.ca.
authors: Maria-Jose
authors: MJ
authors: Santana
authors: David
authors: D
authors: Feeny
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D003657:Decision Making; D019937:Diagnostic Techniques and Procedures / Q000295:instrumentation; D019468:Disease Management; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010349:Patient Compliance; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000379:methods*; D010817:Physician-Patient Relations; D015397:Program Evaluation; D011788:Quality of Life; D012307:Risk Factors; D012648:Self Care / Q000379:methods; D013673:Technology Assessment, Biomedical / Q000379:methods