Patient and healthcare professional perspectives on the Practical Guide to Implementing PROMs in Gender-Affirming Care (PG-PROM-GAC): analysis of open-ended responses from patients and healthcare professionals

Abstract

ImportanceSeveral international calls have been made for evidence-based patient-reported outcome measure (PROM) implementation for gender-affirming care. The Practical Guide to Implementing PROMs in Gender-Affirming Care (PG-PROM-GAC) is a resource which can help guide PROM implementation efforts, developed using a three-phase participatory research approach with transgender and gender-diverse (TGD) patients and gender-affirming healthcare professionals. However, thoughts and perspectives from TGD patients and gender-affirming healthcare professionals on the PG-PROM-GAC need to be investigated.ObjectiveInvestigate patient and healthcare professional perspectives on the PG-PROM-GAC through analysis of open-ended survey results.DesignQualitative study analysing open-ended responses from TGD patients and gender-affirming healthcare professionals.SettingParticipants were recruited from a UK National Health System (NHS) gender clinic.ParticipantsPatients receiving care at an NHS gender clinic and healthcare professionals working at an NHS gender clinic were eligible for participation. Eligible participants were invited to participate in this study via email.InterventionParticipants were sent an open-ended survey to collect responses on the PG-PROM-GAC.Main outcome(s) and measure(s)Data were thematically analysed by two independent researchers and interpreted following guidance from established methods in implementation science.ResultsA total of 64 TGD patients and 9 gender-affirming healthcare professionals responded to the open-ended survey (mean (SD) age: 35 (16) and 48 (8), respectively). Four main themes emerged from the data: overall opinions and support for the PG-PROM-GAC, presentation of the PG-PROM-GAC, impact of gender clinic resources on PROM implementation and impact of PROM selection on implementation. Data were used to iterate the PG-PROM-GAC in response to participant feedback.Conclusions and relevanceThe PG-PROM-GAC is an acceptable and feasible resource that can be used by clinicians, researchers and policymakers to guide PROM implementation for gender-affirming care settings, helping to align gender-affirming care with patient needs.

Practical guide to implementing patient-reported outcome measures in gender-affirming care: evaluating acceptability, appropriateness and feasibility

“…To overcome this limitation, our team is conducting a qualitative study of TGD patients and healthcare professionals on their feedback for the PG-PROM-GAC. 29 Finally, there is a need to actually implement, use, and evaluate the PG-PROM-GAC. The strength of our study from an implementation science perspective is that we have done an a priori analysis of acceptability, appropriateness and feasibility.…”