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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

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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.

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 5130 rue Fabre, Montreal, QC, Canada

    Diana Zidarov & Sara Ahmed

  2. Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montreal, QC, Canada

    Diana Zidarov & Sara Ahmed

  3. McGill Integrated University Health Network (RUIS) Centre of Expertise in Chronic Pain, Montreal, QC, Canada

    Regina Visca & Sara Ahmed

Authors
  1. Diana Zidarov
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  2. Regina Visca
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  3. Sara Ahmed
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Correspondence to Sara Ahmed.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Appendix 1: Extract from the survey: sample question for one from the 19 dimensions of HRQoL

Appendix 1: Extract from the survey: sample question for one from the 19 dimensions of HRQoL

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Zidarov, D., Visca, R. & Ahmed, S. 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 28, 2761–2771 (2019). https://doi.org/10.1007/s11136-019-02215-8

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  • DOI: https://doi.org/10.1007/s11136-019-02215-8

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