Assessing patient-reported outcome measures in specialized palliative care units: a multicenter cohort study across Austrian hospitals

Background Patient-reported outcome measures (PROMs) are essential tools with versatile applications for clinical decision making, care quality improvement and research, but their assessment feasibility relies heavily on patient characteristics and care settings and has so far been limited in palliative care. Therefore, we aimed to comprehensively assess the feasibility of routine, national-level PROMs collection in specialized palliative care units in Austria. Methodology A multicenter cohort study was conducted across 12 specialized palliative care units in Austrian hospitals between October 2021 and April 2023. Eligible patients were invited to complete PROMs independently or with assistance, focusing on quality of life, wellbeing, and symptoms (EQ-5D-5L, ICECAP-SCM, IPOS). Assessments occurred at admission and one-week and two-week follow-ups. Participation and completion rates, need for assistance, and repeated measurement feasibility were assessed alongside patient characteristics. Results Among the 2289 admitted patients screened for eligibility, 325 (14%) met the study criteria, of whom 293 (90%) agreed to participate. Across centers, the proportion of admitted patients who were both eligible and participated in the PROMs assessment ranged from 7% to 31%. Participants were more often female, had cancer and significantly higher pain scores compared to eligible non-participants. Most patients needed assistance (62%). Assessment at all three timepoints was feasible for 47% of the participants. Common reasons for discontinuation included death (38%), health deterioration (25%), or discharge or transfer (21%). Conclusions PROMs assessment in Austrian inpatient specialized palliative care units is only feasible for a subset of patients with most patients requiring support. Our findings highlight important further limitations of PROMs assessment in this context and the need for substantial additional resources for assessment support together with realistic logistical planning in shaping future routine evaluation strategies.