Acceptability, Appropriateness and Feasibility of PROM and PREM Use in Swiss General Internal Medicine Divisions: A descriptive, sequential mixed method study.

BackgroundPatient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly used to integrate patient perspectives into healthcare delivery, yet their routine implementation in general internal medicine (GIM) remains limited. This study evaluated participation rates and the acceptability, appropriateness, and feasibility of collecting PROMs and PREMs among GIM patients and study nurses across five Swiss university hospitals. MethodsWe conducted a sequential mixed-methods study embedded in a larger multicenter trial involving inpatients with two or more chronic conditions, hospitalized for acute illness and study nurses from GIM divisions. Inpatients completed three generic PROMs (paper or digital) at day 3, discharge, and 10 and 30 days post-discharge: the ESAS-r (Edmonton Symptom Assessment System revised), the EQ-5D-5L (European Quality of Life 5 Dimensions 5 Level), and the Distress Thermometer. A customized PREM assessing perceived quality of care was collected at discharge only. Patients and study nurses rated acceptability, appropriateness, and feasibility using Weiners implementation outcome measures. Study nurses recommendations for clinical integration were explored subsequentially in a focus group. Quantitative data were analyzed using descriptive analyses, while qualitative data were analyzed thematically. ResultsAmong 1,773 eligible GIM inpatients, 59% (median age 72 years, IQR 63-81) agreed to participate in PROM and PREM collection. Overall, patients rated all the PROMs as highly acceptable, appropriate, and feasible. Study nurses rated the ESAS-r and the EQ-5D-5L accordingly but expressed a moderate rating for the Distress Thermometer and the PREM primarily for their ease of use. Focus group findings emphasized staff training, digital integration into electronic medical records, reduced questionnaire burden, and hierarchical support as key implementation facilitators. ConclusionOur study demonstrates that PROM and PREM collection in Swiss University Hospital Settings was considered acceptable, appropriate, and feasible by patients and study nurses in a multicentric GIM inpatient setting. Routine implementation warrants specific strategies. SUMMARY TABLEO_ST_ABSWhat is already known on this topicC_ST_ABSO_LIPROMs and PREMs are widely used in many medical specialties to incorporate patient perspectives and evaluate the quality and value of care. C_LIO_LIRoutine use of patient-reported measures in acutely ill GIM inpatients living with multimorbidity remains limited. C_LIO_LIImplementation often faces barriers related to workload, workflows, and digital infrastructure. C_LI What this study addsO_LITwo-thirds of acutely ill GIM inpatients in Swiss University Hospitals living with multimorbidity are willing to participate in PROM and PREM collection. C_LI How this study might affect research, practice or policyO_LIStaff training, digitalization, and hierarchical support are key facilitators, and embedding tools into electronic medical records with fewer measures may improve adoption in GIM. C_LI