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Research ArticleOriginal Research

Stakeholder Engagement in a Patient-Reported Outcomes (PRO) Measure Implementation: A Report from the SAFTINet Practice-based Research Network (PBRN)

Bethany M. Kwan, Marion R. Sills, Deborah Graham, Mika K. Hamer, Diane L. Fairclough, K. E. Hammermeister, Alicyn Kaiser, Maria de Jesus Diaz-Perez and Lisa M. Schilling
The Journal of the American Board of Family Medicine January 2016, 29 (1) 102-115; DOI: https://doi.org/10.3122/jabfm.2016.01.150141
Bethany M. Kwan
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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Marion R. Sills
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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Deborah Graham
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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Mika K. Hamer
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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Diane L. Fairclough
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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K. E. Hammermeister
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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Alicyn Kaiser
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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Maria de Jesus Diaz-Perez
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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Lisa M. Schilling
the Departments of Family Medicine (BMK), Pediatrics (MRS), and Emergency Medicine (MRS), and Divisions of Cardiology (KEH) and General Internal Medicine (LMS), Department of Medicine, and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (BMK, MRS, MKH, DLF, KEH, LMS), University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Aurora, CO (MRS); The DARTNet Institute, Aurora, CO (DG); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (DLF); Metro Community Provider Network, Englewood, CO (AK); Salud Family Health Centers, Fort Lupton, CO (MdJD-P).
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Abstract

Purpose: Patient-reported outcome (PRO) measures offer value for clinicians and researchers, although priorities and value propositions can conflict. PRO implementation in clinical practice may benefit from stakeholder engagement methods to align research and clinical practice stakeholder perspectives. The objective is to demonstrate the use of stakeholder engagement in PRO implementation.

Method: Engaged stakeholders represented researchers and clinical practice representatives from the SAFTINet practice-based research network (PBRN). A stakeholder engagement process involving iterative analysis, deliberation, and decision making guided implementation of a medication adherence PRO measure (the Medication Adherence Survey [MAS]) for patients with hypertension and/or hyperlipidemia.

Results: Over 9 months, 40 of 45 practices (89%) implemented the MAS, collecting 3,247 surveys (mean = 72, median = 30, range: 0 - 416). Facilitators included: an electronic health record (EHR) with readily modifiable templates; existing staff, tools and workflows in which the MAS could be integrated (e.g., health risk appraisals, hypertension-specific visits, care coordinators); and engaged leadership and quality improvement teams.

Conclusion: Stakeholder engagement appeared useful for promoting PRO measure implementation in clinical practice, in a way that met the needs of both researchers and clinical practice stakeholders. Limitations of this approach and opportunities for improving the PRO data collection infrastructure in PBRNs are discussed.

  • Comparative Effectiveness Research
  • Hypertension
  • Medication Adherence
  • Patient Outcome Assessment
  • Patient-centered Outcomes Research
  • Practice-based Research
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The Journal of the American Board of Family     Medicine: 29 (1)
The Journal of the American Board of Family Medicine
Vol. 29, Issue 1
January-February 2016
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Stakeholder Engagement in a Patient-Reported Outcomes (PRO) Measure Implementation: A Report from the SAFTINet Practice-based Research Network (PBRN)
Bethany M. Kwan, Marion R. Sills, Deborah Graham, Mika K. Hamer, Diane L. Fairclough, K. E. Hammermeister, Alicyn Kaiser, Maria de Jesus Diaz-Perez, Lisa M. Schilling
The Journal of the American Board of Family Medicine Jan 2016, 29 (1) 102-115; DOI: 10.3122/jabfm.2016.01.150141

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Stakeholder Engagement in a Patient-Reported Outcomes (PRO) Measure Implementation: A Report from the SAFTINet Practice-based Research Network (PBRN)
Bethany M. Kwan, Marion R. Sills, Deborah Graham, Mika K. Hamer, Diane L. Fairclough, K. E. Hammermeister, Alicyn Kaiser, Maria de Jesus Diaz-Perez, Lisa M. Schilling
The Journal of the American Board of Family Medicine Jan 2016, 29 (1) 102-115; DOI: 10.3122/jabfm.2016.01.150141
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Keywords

  • Comparative Effectiveness Research
  • Hypertension
  • Medication Adherence
  • Patient Outcome Assessment
  • Patient-centered Outcomes Research
  • Practice-Based Research

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