Using an electronic patient reported outcome measures system in UK chiropractic practices: a feasibility study of routine collection of outcomes and cost

Diment, Emily, Newell, David and Bolton, Jennifer (2015) Using an electronic patient reported outcome measures system in UK chiropractic practices: a feasibility study of routine collection of outcomes and cost. Journal of Manipulative and Physiological Therapeutics. (doi:10.1016/j.jmpt.2015.12.001).

Abstract

Objective
The purpose of this study was to test the feasibility of collecting valid and widely used health outcomes, including information concerning cost of care, using a Web-based patient-driven patient-reported outcome measure (PROM) collection process within a cohort of UK chiropractic practices.
Methods
A Web-based PROM system (Care Response) was used. Patients with low back and neck pain were recruited from a group of chiropractic practices located in the United Kingdom. Information collected included demographic data, generic and condition-specific PROMs at the initial consultation and 90 days later, patient-reported experience measures, and additional health seeking to estimate costs of care.
Results
A group of 33 clinics provided information from a total of 1895 patients who completed baseline questionnaires with 844 (45%) completing the measures at 90-day follow-up. Subsequent outcomes suggest that more than 70% of patients improved over the course of treatment regardless of the outcome used. Using the baseline as a virtual counterfactual with respect to follow-up, we calculated quality-adjusted life years and the cost thereof resulting in a mean quality-adjusted life years gained of 0.8 with an average cost of £895 per quality-adjusted life year.
Conclusion
Routine collection of PROMs, including information about cost, is feasible and can be achieved using an online system within a clinical practice environment. We describe a Web-based collection system and discuss the choice of measures leading to a comprehensive understanding of outcomes and costs in routine practice.

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Contributors

Author: David Newell

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