Abstract

Background: Patient reported outcome measures (PROMs) and patient reported experience measures (PREMs) have been fundamental to the NHS. PROMs2.0 allows collection and analysis of outcome data. We assess PROMs and PREMs for elective foot and ankle surgery. We also look at the use of PROMs as a new patient-based audit system, and how to improve participation.

Patients and methods: Scores used to asses PROMs- EQ-5D VAS and EQ-5D Health Index, and MOxFQPROMs data collected pre/post-operatively (follow-up 6 months) PREMs data collected using Picker Patient Experience questionnaire (PPE-15) postoperatively. 97 patients responded (27.7% participation) Non-responders contacted to assess lack of engagement.

Results: Average MOxFQ improved- Pain: 51.4-28.2. Walking/standing:53.5-30.4. Social interaction:46.1-27.3. (p< 0.00001). Average EQ-5D improved. VAS: 76.0-79.7 (p=0.033), Index: 0.70-0.74. (p=0.002) (Comparable to knee-arthroplasty).

Patients aged 70+ -greatest MOxFQ improvement (p=0.020), < 50 and 70+/-greatest EQ-5D improvement (P=0.01). Males reported better outcomes in MOxFQ(p=0.024) Left-sided procedures better than right-not significant. Non-participation- 20/30-lack time, 7/30-No Internet, 3/30- non-specified. 66.1%+ PPE-15 favourable. Asking questions and sharing of information highest-scorers (80.8%+80.2%). Family involvement-most potential for improvement. (47.7%) 55-64 age group -greatest overall satisfaction, highest in 6/7 domains. (p=0.663) Equally satisfactory experience amongst men/ women (p=0.596) Results similar to published data.

Conclusion: Post-op improvement. Better outcomes with increased age and male sex. Overall satisfactory patient reported experience. PROMs are an important outcome tool of increasing importance, as we move away from manual collection. However, it still needs optimising for us to take maximum benefit from what it offers and to increase participation. Level 3-Prospective data

Keywords: Patient reported outcomes; Foot and ankle surgery; PROMs