The impact of implementing patient‐reported measures in routine maternity care: a systematic review

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 101; no. 11; pp. 1184 - 1196
• Main Authors: Chen, An, Väyrynen, Kirsi, Schmidt, Alexandra, Leskelä, Riikka‐Leena, Torkki, Paulus, Heinonen, Seppo, Tekay, Aydin, Acharya, Ganesh
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.11.2022; Wiley; John Wiley and Sons Inc
• Subjects: Delivery of Health Care; Female; healthcare quality; Humans; impact; implementation; Maternal child nursing; Maternal Health Services; maternity care; Medicin och hälsovetenskap; patient reported measure; Patient Reported Outcome Measures; Pregnancy; pregnancy and childbirth; Prenatal Care; Professional relationships; Quality of Life; Systematic Review; Systematic Reviews; Womens health; healthcare quality; pregnancy and childbirth; patient reported measure; impact; implementation; maternity care
• ISSN: 0001-6349; 1600-0412; 1600-0412
• DOI: 10.1111/aogs.14446

Introduction While there is growing interest in applying patient‐reported measures (PRMs) in clinical routine, limited collective evidence of the impact of PRMs hinder their widespread use in specific contexts, such as maternity care. Our objective was to synthesize existing emperical evidence on the impact of implementing PRMs in routine maternity care. Material and methods We followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines (version 2020). We electronically searched six databases for the literature on the implementation of PRMs in maternity care. A multi‐level (woman, clinical, organizational, national and societal) analytic framework for analyzing and synthesizing emperically proven impacts of PRMs was developed. Quality was assessed using the Mixed Method Appraisal Tool. The GRADE‐CERQual approach was used to assess the confidence in the review findings and arguments. The protocol was registered in PROSPERO (CRD42021234501). Results Overall, 4971 articles were screened. The emperical evidence, collected from 11 relevant studies, showed that the use of PRMs in routine maternity care could produce positive effects on clinical process (assessment and detection of health problems, clinical visit preparation, resource use, woman–professional communication, decision‐making, woman–professional relationship, and care quality), and health behavior and outcomes (women's health and wellbeing, quality of life, health behavior, experiences and satisfaction with healthcare services), awareness, engagement and self‐management of own health, and disclosure of health issues. The confidence in the review findings was low to moderate due to a limited number of studies, inadequate data and methodological limitations of included studies. Conclusions The limited emperical evidence available suggested that the use of PRMs may have positive effects at the individual health level and clinical process level. However, the evidence was not strong enough to provide policy recommendations on the use of PRMs in routine maternity care. This review revealed limitations of currently available research, such as lack of generalizability and narrow scopes in investigating impact. Efforts are needed to improve the quality of research on the use of PRMs in routine maternity care by widening the study population, including different types of PRMs, and considering the effects of PRMs at different levels and domains of healthcare. The limited emperical evidence tentatively suggested that the routine use of patient‐reported measures in maternity care could have positive effects at individual health level and clinical level, but currently available evidence was far from convincing and consistent, and the confidence on the review findings was low to moderate.