Trends of Patient-reported Outcome Measures (PROMs) in Multimorbid Medical Patients Hospitalized for an Acute Illness

University of Lausanne Hospitals1,000 enrolled

Overview

currently, PROMs and PREMs are not routinely collected and compared among medical inpatients of Swiss university hospitals, nor is a standard set of PROMs and PREMs available for use in Swiss hospitals. The project aims to examine trends in patient-reported outcomes (PROMs), including symptoms, quality of life, and distress, in multimorbid hospitalized patients from admission to 30 days post-discharge. It will also investigate whether PROMs at discharge are linked to the risk of readmission or emergency visits and explore how these outcomes differ in patients who receive low-value care. Additionally, the project will assess the relationship between patient-reported experiences (PREMs) and the provision of low-value care during the hospital stay.

Study Type

OBSERVATIONAL

Enrollment

1,000

Conditions

PROM PREM Quality of Care Internal Medicine

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * eligible for the LUCID registry (CER-VD AO\_2023-00029) \[Age ≥ 18 years, hospitalized in one of the five participating university hospitals (Geneva, Lausanne, Bern, Zürich, Basel), after 01.01.2014, and admitted to general internal medicine wards * Multimorbid patients (2 or more chronic diseases, defined as chronic conditions defined by international classification of diseases, 10th revision, codes with an estimated expected duration of at least 6 months or based on a clinical decision. * Acute illness * Signature of study specific informed consent Exclusion Criteria: * Not able to speak French, German or English * Foreseen length of stay of less than 4 days (estimated by study collaborators) * Prior inclusion in the TRADUCE study * Incapacity of discernment, i.e. cognitive impairment which could interfere with the ability to fill in PROMs tools

Outcomes

Primary Outcomes

Correlation of PROMS with the risk of readmission

The primary objective of the project is to explore trends in PROMs (using the Edmonton Symptom Assessment System (ESAS-r), the EQ-5D-5L index,45 and the National Comprehensive Cancer Network (NCCN) distress thermometer) of multimorbid medical hospitalized patients, from admission until 30-days post-discharge. The patients-reported outcomes will consist of patients-reported symptoms, quality of life and distress

Time frame: Day 1, Day 3, at the day of discharge (approximately day 8) and Day 30 after discharge from Hospital

Secondary Outcomes

Correlation of PROMs at discharge and risk of hospital readmission or ED visits

assess whether PROMs ((using the Edmonton Symptom Assessment System (ESAS-r), the EQ-5D-5L index,45 and the National Comprehensive Cancer Network (NCCN) distress thermometer) at discharge are associated with the risk of hospital readmission or of emergency department visit within the next 30 days;

Time frame: Day 30 after discharge from hospital

Exploration of PROMs in patients who receive low-value care

explore whether PROMs ((using the Edmonton Symptom Assessment System (ESAS-r), the EQ-5D-5L index,45 and the National Comprehensive Cancer Network (NCCN) distress thermometer) trends vary in patients who do or do not receive low value care (LVC);

Time frame: Day 1, Day 3, at the day of discharge (approximately day 8) and Day 30 after discharge from Hospital

Explore PREMs

Explore information on Patient Reported Experiences Measures (PREMs) using a qualitative questionnaire during patients' stay at the hospital, and whether there is a correlation between the provision of LVC and qualitative analysis of PREMs

Time frame: Since 24 hours after beginning of the hospitalization up to Discharge from Hospital (approximately day 8)