Type of clinical outcomes used by healthcare professionals to evaluate health-related quality of life domains to inform clinical decision making for chronic pain management

Qual Life Res. 2019 Oct;28(10):2761-2771. doi: 10.1007/s11136-019-02215-8. Epub 2019 May 28.

Abstract

Purpose: To evaluate the health-related quality of life (HRQoL) domains currently assessed by healthcare professionals (HCPs) in secondary and tertiary hospital-based chronic pain clinics and the type of clinical outcomes (CO) used.

Methods: Electronic cross-sectional survey (May to September 2016) based on domains of HRQoL included in the Patient-Reported Outcomes Measurement Information System (PROMIS) framework.

Results: HCPs response rate was 53% (36/68). Their mean clinical experience was 14.8 years (± 11.1), and their mean experience treating chronic pain (CP) population was 10.2 years (± 7.8). All PROMIS-HRQoL domains were assessed by HCPs (range 28-97%, mean = 64%) with a preponderance of domains related to physical health (mean = 82%). Standardized outcome measures (OMs) including performance outcomes and patient-reported outcomes (PROs) were not frequently used (mean 0.5% and 3%, respectively) for assessing HRQoL domains compared to clinician reported outcomes (patient interviews, patient observation) (mean = 87%). Forty different OMs for assessing HRQoL domains were reported, and 30% of OMs were used by more than one HCP. HCPs expressed a need (range from 2.3 to 26.3%) for using more than one type of CO for assessing most domains of HRQoL (range from 2.3 to 26.3%) with a preference of using more PROs combined with CROs.

Conclusions: All domains of HRQoL are assessed by at least some HCPs for chronic pain management. Standardized OMs including performance-based measures and PROs were not frequently used, and there was no consistent use of the same OM across HCPs. A consensus among different stakeholders in chronic pain management on core domains of HRQoL and their associated OMs to promote a more evidence-based assessment is needed.

Keywords: Chronic pain; Clinical outcomes; Evaluation; Health-related quality of life; Healthcare professionals; Survey.

MeSH terms

  • Chronic Pain / psychology*
  • Chronic Pain / therapy*
  • Clinical Decision-Making / methods*
  • Cross-Sectional Studies
  • Female
  • Health Personnel / psychology*
  • Humans
  • Pain Management / psychology*
  • Patient Reported Outcome Measures*
  • Quality of Life / psychology*