Natasha Roberts, BN (hons)
Royal Brisbane and Women’s Hospital

In 2017, the Clinical Practice Special Interest Group (CP-SIG) identified an opportunity to bring together ISOQOL members interested in using implementation science (IS) with patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). The ISOQOL PROMs/PREMs in Clinical Practice Implementation Science Work Group was formed, with members from five countries. To share experiences across the ISOQOL community, a workshop was given at the 25th Annual ISOQOL 2018 Conference in Dublin, titled, ‘What is implementation science and how can it help us integrate PROMs into clinical practice?’  It was updated for the 26th Annual ISOQOL 2019 Conference in San Diego. From these workshops, the work group consolidated an evidence base. At the 27th Annual ISOQOL 2020 Conference (Virtual), ‘Using an implementation science approach to implement and evaluate patient reported outcome measures (PROM/PREM) initiatives in routine care settings’ was delivered as a Symposium session. A Supplementary Paper Series for Quality of Life Research was curated using four case studies and an evaluation project exploring measurement of PROMs/PREMs implementation.

The first case study from Canada was, ‘Prospective application of implementation science theories and frameworks to inform use of PROMs in routine clinical care within an integrated pain network.’ Dr. Ahmed and her team used IS theories to both identify the potential barriers and enablers for interdisciplinary PROMs use, and to structure increased PROMs use in clinical practice. The second case study, also from Canada, was, ‘Using implementation science to inform the integration of ePREMs into healthcare quality improvement: description of a theory-based application in primary care.’  Drs. Santana and Manalili prospectively planned use of IS theory to identify key enablers and barriers, establish consensus amongst partners in primary care, and operationalise and evaluate the implementation of electronic patient-reported experience measures (ePREMs).

The third case study, from The Netherlands, was, ‘A retrospective assessment of the KLIK PROM portal implementation using the CFIR framework.’  Dr. van Oers, Dr. Haverman, and colleagues identified key strategies that were effective for ongoing implementation, and also to increase use and uptake of PROMs by healthcare professionals. The fourth case study, from Australia, was titled, ‘The utility of the integrated framework for Promoting Action Research in Health Services (iPARIHS) in a medical oncology department.’  Dr. Roberts and colleagues used iPARIHS, an implementation science framework, to plan, implement and evaluate a symptom PROMs implementation.

Dr. Stover and writing team members summarised the key findings of the case studies and investigated implementation measurement in, ‘Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiative in routine care settings.’ They identified two main findings:

  1. IS strategies can influence not only implementation, but potentially patient clinical outcomes.
  2. Barriers were consistent across the case studies, but enablers appeared context specific, suggesting the need for tailored implementation support for each clinic.

Implementation measures of acceptability, appropriateness, feasibility, fidelity, adoption, reach, cost and sustainability for PROMs implementation were adapted from Proctor and colleagues’ 2011 paper, specifically for PROM/PREM implementation as standard-of-care.

The work group membership continues to build knowledge and expertise within local networks. A workshop was presented at the Australian PROMs “Down Under” Meeting in 2021. The Supplementary Paper Series is available as Open Access from Quality of Life Research Journal and on ISOQOL’s resource page in the endorsed papers section (

This newsletter editorial represents the views of the author and does not necessarily reflect the views of ISOQOL. 

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The International Society for Quality of Life Research (ISOQOL) is a global community of researchers, clinicians, health care professionals, industry professionals, consultants, and patient research partners advancing health related quality of life research (HRQL).

Together, we are creating a future in which patient perspective is integral to health research, care and policy.