Veteran Preferences for Technology-Assisted Patient Reported Outcomes Measurement of Mental Health Symptoms (Preprint)

BACKGROUND The Veterans Health Administration (VHA) is promoting patient-reported outcome measures (PROMs) collection for measurement-based mental healthcare. Understanding Veteran preferences about how and when to complete PROMs is critical to support their implementation. OBJECTIVE We examined Veteran preferences for timing and use of different technology platforms to complete mental health-related PROMs. METHODS We invited a national sample of 1,373 Veterans to complete a survey; 858 (63%) responded. Surveys asked about Veteran preferences for how and when to complete mental health-related PROMs. We characterized responses using descriptive statistics, and estimated multiple logistic regression models to examine associations between Veteran demographic and health characteristics and preferences for completing PROMS. RESULTS Most Veterans preferred completing PROMs between appointments (76%) using features of a patient portal (51%), during appointments (74%) verbally (52%), and while at the medical center (60%) on paper (24%) or a tablet computer (23%). Hispanic (vs. non-Hispanic) Veterans had 3.32 times higher odds of preferring to complete PROMs at the medical center (95%CI:1.04-10.58), and Veterans with lower (vs. higher) socioeconomic status had lower odds (OR:0.61, 95%CI:0.40-0.93) of preferring to complete PROMs in between appointments, but 1.97 times higher odds (95%CI:1.23-3.16) of preferring to complete PROMs during appointments. CONCLUSIONS As VHA and other healthcare systems seek to expand the integration of PROM data into healthcare services, adaptive and flexible approaches to PROM administration that align with patient preferences, including those that leverage technology platforms in the remote collection of these data, may bolster implementation. Our results indicate that such implementation efforts should consider patient ethnicity and socioeconomic status. Our findings further suggest that these efforts could benefit from incorporating PROM administration into online patient portals, developing mobile health apps that support PROMs completion through patient’s personal devices in between clinical encounters, and engaging care team members in PROM administration during appointments. CLINICALTRIAL N/A