Electronic patient-reported outcome measures for triaging and scheduling outpatient appointments: a systematic review and meta-analysis.

Abstract

Objectives: This study aims to review the effectiveness of electronic patient-reported outcome measures (ePROMs) to triage and schedule appointments for adult patients with chronic medical conditions.

Materials and methods: A structured search was implemented in electronic databases for randomized controlled trials that compared use of ePROMs to facilitate flexible scheduling of appointments (intervention) with conventional scheduling practices (control) in adult outpatients with chronic medical condition. The primary outcome was the difference in healthcare utilization, measured by the number of outpatient physical appointments. Secondary outcomes include disease control and implementational outcomes. A meta-analysis using random effects modeling was performed.

Results: The search strategy yielded 3769 citations and 1 additional article from hand search; 17 randomized controlled trials (6469 patients) were included. Most studies focused on cancer (n = 9) or rheumatoid arthritis (n = 3). Six out of 10 studies comparing the number of physical appointments showed that ePROMs significantly reduced the mean number of physical appointments, while 1 study reported increased appointments. A meta-analysis of 6 studies with sufficient data for pooling indicated that the ePROMs group had fewer appointments, with a mean difference of -1.12 (CI, -1.87 to -0.37). Among 10 studies evaluating disease control, 2 showed improved disease control with ePROMs, 2 reported improved survival in cancer patients, while 6 found no significant differences.

Discussion: Current evidence supports the feasibility and acceptability of incorporating ePROMs in outpatient visit scheduling, with a reduction in physical appointments without compromising disease outcomes.

Conclusion: ePROMs can be used to support and guide decisions regarding outpatient appointment scheduling.