<p>The Use of Measurement Systems to Support Patient Self-Management of Long-Term Conditions: An Overview of Opportunities and Challenges</p>

Abstract

Long-term conditions are a major public health concern that present many challenges for patients living with them. There is increasing policy focus on promoting patient self-management and supporting patients to take ownership of managing their conditions. Because long term conditions often fluctuate over time, ongoing monitoring of disease activity is necessary for self-management; this can be achieved through using Patient Reported Outcome Measures (PROMs). PROMs can provide additional information about patients’ symptoms, functioning, and emotional wellbeing, informing clinical care for patients. Measurement systems are an innovative method to gather and report PROMs throughout a patient’s course of care, to support clinical practice and improve overall quality of care. Measurement systems are often delivered via a digital platform, which can convey patient-reported information to healthcare professionals and provide tailored self-management advice to patients, all based on information collected via PROMs. There are a number of potential benefits of this approach to self-management. Measurement systems can improve clinical practice, creating efficient clinical encounters and positively influencing patient-clinician interactions. The use of monitoring throughout a patient’s care is also thought to empower patients, by improving their knowledge of their condition, increasing their engagement with their health, and influencing their overall management of their condition. Challenges associated with using measurement systems in this way include finding appropriate PROMs, provisioning of suitable technology, and limiting the burden for patients. To increase the implementation of measurement systems into practice it is important to consider how to engage and educate healthcare professionals and patients to empower their use. Overall, adopting measurement systems into clinical practice may improve clinicians’ ability to support patient self-management of long-term conditions.

Patients’ and clinicians’ perspectives on the clinical utility of the Rheumatoid Arthritis Foot Disease Activity Index

“…Adopting the RADAI-F5 in clinical settings may be hampered by logistical and technological issues. Participants recommended apps and ePROMs to make RADAI-F5 data more accessible while reducing clinician and administrative workload [ 44 ]. Although the clinical use of apps and ePROMs is still in its infancy, research demonstrates that the general population can use systems with little difficulty [ 45 , 46 ].…”

Making remote measurement technology work in multiple sclerosis, epilepsy and depression: survey of healthcare professionals

“…One of the highest ranked concern s regarding the implementation of RMT in clinical practice in our study was patient adherence to use of the technology. Recent work has highlighted patients’ own concerns with regard to adhering to RMT measurement regimes, for example the bulkiness and visibility of a device meaning it could be stigmatizing [ 38 ], and the fact that responding to momentary sampling questionnaires may not fit with their lifestyle or other commitments [ 39 ]. In addition, our data show that where patients have access to their data, this may cause them anxiety, indicating a need for careful design of dashboards/apps reporting data back to patients.…”

Changes of Health-Related Quality of Life Within the 1st Year After Stroke–Results From a Prospective Stroke Cohort Study

“…Standardized registration of PROMs in the acute and follow-up phase could improve self-management in patients and support physicians to gain information about long-term HRQoL in their patients. To support this, digital measurement systems have already been tested but further research in this area is still needed ( 40 ).…”