title: Training clinicians in how to use patient-reported outcome measures in routine clinical practice.
abstract: BACKGROUND
  Patient-reported outcome measures (PROs) were originally developed for comparing groups of people in clinical trials and population studies, and the results were used to support treatment recommendations or inform health policy, but there was not direct benefit for the participants providing PROs data. However, as the experience in using those measures increased, it became obvious the clinical value in using individual patient PROs profiles in daily practice to identify/monitor symptoms, evaluate treatment outcomes and support shared decision-making. A key issue limiting successful implementation is clinicians' lack of knowledge on how to effectively utilize PROs data in their clinical encounters.
  
  
  METHODS
  Using a change management theoretical framework, this paper describes the development and implementation of three programs for training clinicians to effectively use PRO data in routine practice. The training programs are in three diverse clinical areas (adult oncology, lung transplant and paediatrics), in three countries with different healthcare systems, thus providing a rare opportunity to pull out common approaches whilst recognizing specific settings. For each program, we describe the clinical and organizational setting, the program planning and development, the content of the training session with supporting material, subsequent monitoring of PROs use and evidence of adoption. The common successful components and practical steps are identified, leading to discussion and future recommendations.
  
  
  RESULTS
  The results of the three training programs are described as the implementation. In the oncology program, PRO data have been developed and are currently evaluated; in the lung transplant program, PRO data are used in daily practice and the integration with electronic patient records is under development; and in the paediatric program, PRO data are fully implemented with around 7,600 consultations since the start of the implementation.
  
  
  CONCLUSIONS
  Adult learning programs teaching clinicians how to use and act on PROs in clinical practice are a key steps in supporting patient engagement and participation in shared decision-making. Researchers and clinicians from different clinical areas should collaborate to share ideas, develop guidelines and promote good practice in patient-centred care.
authors.affiliation: W21C Research and Innovation Centre, Institute of Public Health, Faculty of Medicine, University of Calgary, GD01, TRW Building, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada, mjsantan@ucalgary.ca.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Santana
authors.forename: Lotte
authors.initials: L
authors.lastname: Haverman
authors.forename: Kate
authors.initials: K
authors.lastname: Absolom
authors.forename: Elena
authors.initials: E
authors.lastname: Takeuchi
authors.forename: David
authors.initials: D
authors.lastname: Feeny
authors.forename: Martha
authors.initials: M
authors.lastname: Grootenhuis
authors.forename: Galina
authors.initials: G
authors.lastname: Velikova
mesh_terms: D000328:Adult; D003657:Decision Making; D003695:Delivery of Health Care; D006291:Health Policy; D006801:Humans; D063868:Patient Outcome Assessment; D018802:Patient-Centered Care; D016730:Program Development; D011788:Quality of Life / Q000523:psychology*