Clinical integration of digital PROMs in primary healthcare for chronic diseases management - a systematic review

Background: Health measurement guides policies and healthcare decisions and is necessary to describe and attain the quintuple aim of improving patient experience, population health, care team well-being, healthcare costs and equity. In the primary care setting, patient-reported outcome measurement allows outcomes comparison within and across settings, and the improvement of clinical management of patients. However, these digital patient-reported outcomes measures are still not adapted to the clinical context of primary healthcare, an indication of the complexity of integrating these tools in this context. We must then gather evidence of their impact on chronic disease management in primary healthcare and understand the characteristics of effective implementation.

Objective: We conducted a systematic review to identify and assess the impact of ePROMs implantation in primary health care for chronic disease management. Our specific objectives are: (1) Determine the impact of ePROMs in primary health care for chronic disease management. (2) Compare and contrast characteristics of effective ePROMs’ implementation strategies.

Methods: We conducted a systematic review of the literature according to the Cochrane Methods Group and in compliance with the PRISMA Guidelines for its reporting. A specific search strategy was developed for relevant databases to identify studies. Two reviewers independently applied the inclusion criteria using the full texts and extracted the data. We used a two-phase sequential mixed methods synthesis design by conducting a qualitative synthesis first, and use its results to perform a quantitative synthesis.

Results: 12524 sources were identified, 3993 duplicates were removed, 8467 titles and abstracts were screened and 661 full-text were screened. We are currently in the analysis process and we are using the RE-AIM framework to present our results regarding Reach, Efficacy, Adoption, Implementation and Maintenance. The completed analysis will be presented at the time of the conference.

Conclusions: Results from this study help support implementation efforts to accelerate innovations and digital adoption for primary healthcare and will be relevant for improving clinical management of chronic diseases, healthcare services and policies.

PROSPERO Systematic Review Registry (ID: CRD42022333513).