Proms – you probably haven’t heard of them, until a few years ago, I hadn’t heard of them either. It stands for Patient Reported Outcome Measures or PROM. They are a way of collecting information from patients about how they feel after treatment. PROM are tools which are used across healthcare. The information they provide helps professions understand how the treatment and care they give makes a difference to their patients, and different aspects of their life.

 Sound good? Sounded like a good idea to me. I like to get feedback on the way my treatment makes you feel.  I decided that this was not only a good idea for me but seemed like it would help my whole profession. By giving osteopathy much needed evidence about practice.  I registered my interest with the National Centre for Osteopathic Research or NCOR and waited for my first set of codes to arrive.  Carol Fawkes from NCOR has developed to the PROMs system and analyses the results, so I don’t even have to do the number crunching. Win win!

The PROMs system is used electronically now since the onset of Covid-19.  I received a set of 50 codes and I give a code to each new patient, or a former patient returning with a new episode of symptoms.  The code sheet is accompanied by a Participant Information Sheet which is sent to each patient by email with some additional text about the study.  I also received a guide to using POROMs, a document about technical information, and copies of two posters to display in my practice.  The thing that I hadn’t expected was that I was nervous about asking patients to fill in the PROM questionnaire. This came as a real surprise. 

At this point I had been in practice for 20 years, why was I nervous? I thought about this a great deal before embarking on sending out  my first PROM code. I get feedback every week both positive and negative from returning patients. I am good at reflecting on what has happened and judging whether I could have taken a different perspective or action, I can discuss this with patients and come to decisions with them in partnership. What made this different? I reflected that although the data was anonymous I felt that I was being watched and at some level judged by someone else in a way I hadn’t felt before. A third party who wasn’t in the treatment room with me, would this mean that the subtlety of an interaction would be lost in this third party interpretation? This got me to reflect on what type of judgement someone else could make on my treatment and the treatment outcomes. I took strength from this perspective. This helped me feel better as I knew that being judged by my peers would be a good thing. I did still feel very self conscious handing out the first few codes. I tried to face my fear of the unknown researcher who I was inviting in. A person who would only hear one side of the story of the interaction and not mine. I realised that only my patient and my Judgement mattered. The responses from patients are anonymous so really all of this was in my head.

What would you expect as a new patient? After I have taken your case history I ask if you have any questions about what we have talked about or if you have anything to add. I ask patients if they have received the link to the PROMs questionnaire and ask if they have any questions or comments about it.   

There are four short questionnaires. The first one to be completed prior to treatment if there is time or on the day of the first appointment The second is sent out electronically direct to the patient one week after the first, the third after six weeks, and the final one at three months after the initial appointment. The study  is finished then and you will not be contacted again. Many people tell me they cannot be bothered with doing emails or have too much on. I find their honesty refreshing and don’t bring the subject up again. Patients who decide to take part often talk about how they found the questions, it seems that it offers a point of reference for personal reflection.I have certainly noticed that there is a definite up serge in repeat visits at the six week point if people still have some symptoms. So it seems to work as a reminder too.

For what is a small amount of effort on my part the rewards are certainly worth it.