Feasibility of patient-reported outcome research in acute geriatric medicine: an approach to the ‘post-hospital syndrome’

BACKGROUND: A patient's self-reported health-related quality of life (HRQoL) can be quantified by a patient-reported outcome measure (PROM). A patient's HRQoL can provide another avenue to understand the 'post-hospital syndrome', a period after hospital discharge that a patient remains vulnerable to subsequent re-admission. The purpose of the study was to establish the feasibility of collecting HRQoL of older inpatients treated for acute illnesses on medical ward. Feasibility of the PROM would be qualitatively judged upon completion time, response rate and sensitivity to change in HRQoL over time. METHODS: A prospective observational cohort of consecutively admitted patients to a step-down medical ward over 1 year. The COOP/WONCA chart was the PROM. Patients were interviewed by the author face-to-face within 48 hours of admission and then 2 weeks after discharge by telephone. RESULTS: From the 300 patients admitted, 182 were excluded. Of the remaining 118, median age was 78 years (interquartile range, IQR, 64-86 years), and 71 (60.2%) were female. Proxies were used for 26 (22%) patients. Ninety-two (78%) completed follow-up. The participants were contacted at a median of 14 days (IQR, 13-16) after discharge. Exploratory analyses found that the COOP/WONCA had test-retest responsiveness, that is detected change in HRQoL over time. CONCLUSION: The completion time of 3 minutes, high response rate (78%) and test-retest responsiveness are evidence that collecting PROs from acutely unwell elderly patients using the COOP/WONCA is feasible. PRO research could become fundamental to the understanding of the 'post-hospital syndrome'.