The acceptability of implementing patient‐reported measures in routine maternity care: A systematic review

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 102; no. 4; pp. 406 - 419
• Main Authors: Chen, An, Väyrynen, Kirsi, Leskelä, Riikka‐Leena, Torkki, Paulus, Heinonen, Seppo, Tekay, Aydin, Acharya, Ganesh
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.04.2023; Wiley; John Wiley and Sons Inc
• Subjects: acceptability; Clinical medicine; Data collection; Delivery of Health Care; Female; healthcare quality; Humans; implementation; Maternal child nursing; Maternal Health Services; maternity care; Medicin och hälsovetenskap; patient reported measure; Patient Reported Outcome Measures; Patient-centered care; Pregnancy; pregnancy and childbirth; Prenatal Care - methods; Systematic Review; healthcare quality; pregnancy and childbirth; patient reported measure; implementation; maternity care; acceptability
• ISSN: 0001-6349; 1600-0412; 1600-0412
• DOI: 10.1111/aogs.14506

Introduction Patient‐reported measures (PRMs) are becoming popular as they might influence clinical decisions, help to deliver patient‐centered care, and improve health care quality. However, the limited knowledge and consensus about the acceptability of implementing PRMs in maternity care hinder their widespread use in clinical practice, and evidence‐based recommendations are lacking. This systematic review aims to synthesize available evidence on the acceptability of implementing PRMs in routine maternity care. Material and methods Literature on the implementation of PRMs in maternity care was electronically searched in six databases (PsycARTICLES, PubMed, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and CINAHL), screened and selected for the topic of “acceptability”. Theoretical Framework of Acceptability was used as the basic framework guiding data analysis and synthesis. Evidence was thematically analyzed and synthesized. Mixed Method Appraisal Tool and GRADE‐CERQual approach were used to assess the quality of studies and evaluate the confidence in the review findings. Results Overall, 4971 articles were screened. From 24 studies, we identified five themes regarding the acceptability of implementing PRMs in routine maternity care: (1) user's action and behavior, (2) stakeholders' attitudes, (3) perceived benefits, (4) perceived challenges and risks, and (5) stakeholders' preferences and suggestions on implementation. While pregnant and postpartum women, health professionals and other stakeholders involved in maternity care were generally positive about the implementation of PRMs in routine care and recognized the potential benefits (eg health improvement, women empowerment, care and services improvement and healthcare system advancement), they pointed out possible challenges and risks in answering PRMs questions, responding to answers, and setting up integrated information systems as well as suggested solutions in the aspects of PRMs data collection, follow‐up care, and system‐level management. The confidence in the review findings was moderate due to methodological limitations of included studies. Conclusions Available empirical evidence suggested that the use of PRMs in routine maternity care is acceptable among stakeholders involved in maternity care and the potential benefits of its integration in routine clinical practice to healthcare improvement has been recognized. However, possible challenges in data collection, follow‐up care arrangement and system‐level integration should be appropriately addressed. There was limited knowledge and consensus about the acceptability of implementing patient‐reported measures in maternity care. This systematic review synthesizes available evidence on the acceptability of implementing PRMs in routine maternity care. It finds that routine use of PRMs is acceptable among stakeholders (primarily women and health professionals) involved in maternity care, but improvements are required in data collection, follow‐up care arrangement and system‐level integration.