Rooting patient-reported outcomes in clinical care: a scoping review on benefits, challenges, and opportunities for patients and clinicians

BACKGROUND: The patient voice in healthcare continues to grow, through the expanded use of patient-reported outcomes (PRO) and enhanced by the growing use of digital health technologies. Despite these positive signs, widespread adoption of PRO measures (PROM) in healthcare decision-making continues to lag. We conducted a scoping review to identify the current benefits of and roadblocks to the use of PRO data in the patient-clinician interaction. METHODS: We searched the Embase and MEDLINE databases from 2014 to 2024 for articles that discussed the role of PRO data in patient quality of life, clinical care and value assessment decision-making. We also manually searched the websites of nine national health technology assessment agencies and used a snowballing approach to identify additional publications. Eligible publications were mapped to three key topics of interest: benefits/barriers at the patient, clinician, and healthcare service levels. RESULTS: Our search yielded 1,846 citations; after deduplication and screening, 13 articles were included. At the patient level, benefits included increased care satisfaction and improved patient experience, mainly via enhanced communication. Uncertainty about PROMs and their mechanisms was a main barrier, as were concerns about the variability of clinical application, lack of follow-up, and unfulfilled patient expectations. For clinicians, improved patient symptom clarity, satisfaction with care, and informed decision-making were the main benefits of PROMs, along with improved efficiency during patient visits. The main barrier for physicians was the feasibility of integrating PROMs into daily practice, including establishing the routine use of PROMs, and consistency in the interpretation of PRO data. At the healthcare service level, improvements in efficiency and the identification of unmet needs were benefits, while questions about consistent between-group interpretation were raised, as were questions regarding the basic value of PROMs, as there is currently minimal evidence to indicate that PRO data directly improve care outcomes. CONCLUSION: Much evidence exists indicating PROMs are associated with improvements in patient-clinician communication and improved satisfaction on both parts, although hesitation regarding their widespread adoption remains. More objective data are needed to further quantify the potential benefits of PROM integration in clinical care in order to assess any direct impact on clinical care outcomes and to facilitate their broader use.