Enhancing Patient Response to Patient Reported Outcome Measures (PROMs): Insights from a Leading Dutch University Hospital.

Objectives: Engaging patients with Patient Reported Outcome Measures (PROMs) is a widely recognized and pressing challenge, yet our understanding of how to achieve this is limited. This study investigated strategies implemented by a Dutch university hospital aimed at enhancing response rates among outpatients from nearly 70 subdepartments. Response rates improved, but remained below desired levels. To deepen understanding and inform future strategies, we identified patient and consultation characteristics associated with response behavior.

Methods: We investigated strategies and their underlying rationales through document analysis of internal hospital documentation (2020-2023) using the COM-B model. We exploited electronic health record data to identify patient and consultation characteristics associated with PROMs completion, estimating a multivariate logistic regression model (n= 46,468 outpatient consultations).

Results: Thirteen strategies targeted outpatients' capability, opportunity, and motivation to complete PROMs. In 2023, PROMs were completed in over half (56%) of the 46,468 unique consultations for which a PROM was sent. Challenges persisted in establishing effective feedback mechanisms and accommodating non-Dutch speaking patients. The multivariate analysis showed significantly higher response among patients of high or middle socioeconomic status and those with an in-person consultation, i.e. not using telehealth. Women, patients attending a follow-up visit, or those having their consultation on a Friday were slightly less likely to complete PROMs.

Conclusions: Response rates to PROMs improved but remained below desired levels, despite multiple strategies. Hospitals may benefit from effective patient feedback on PROMs and tailoring strategies to engage specific patient groups. These approaches can enhance successful implementation and promote equity in VBHC.