Angela Rylands, Patient Centred Outcomes Consultant at pH Associates Ltd (An OPEN Health company) reviews a recent Pharmafocus article "Healthcare exists to improve and extend people's lives", Pharma must seize this opportunity to embed robust PCO measurement into the next generation of healthcare solutions.
"Healthcare exists to improve and extend people's lives", described the authors of a recent 'Pharmafocus' article (May 2017). “When it comes down to it..”, the authors assert, “..the ultimate measure of success of any treatment is the actual impact it has on the patient”. Presumably, treatment should make life easier for the individual with a health condition, by allowing the individual to go about their daily living, with minimal obstruction from their health related issues. The ability to measure the actual impact of a treatment on the patient, means being able to evaluate health-care outcomes in 'real', human terms. But how can we do this accurately?
Fortunately, there are a number of robust and reliable ways of measuring the 'real' impact of treatment on patients, commonly referred to patient centred outcomes (PCOs), or patient reported outcomes (PROs). PCO measures are carefully designed questionnaires, or instruments that allow patients to describe aspects of their health, healthcare or treatment in a way that is meaningful to them. In other words, PCO measures can tell us about how a treatment is impacting an individual's life. For example, a PCO may tell us how well a patient is getting on with their day-to-day tasks, their ability to dress or wash, or go to work, or to spend time with friends and family. Whatever it is that patients with a particular condition have identified as important, these are the things (or ‘concepts’) that patients are often concerned about their condition or treatment disrupting. Perhaps patients’ 'real' aspirations about treatments are that they enable the individual to get on with usual daily lives as normally as possible. Your next question may be; how do we know what the patients want, unless we ask them?
Well-designed PCO measures have done just that; in the development phases of valid and acceptable PCO instruments (according to the European Medical Agency [EMA] and Food and Drug Administration [FDA] guidelines), a group of patients with a particular condition will have been interviewed extensively to determine the most pertinent aspects of their daily living that are affected by their condition. A robust PCO instrument will have been meticulously designed to include the 'items' or 'concepts' outlined by the patients during carefully structured interviews or focus groups. After several iterations of refinement and psychometric validation with clinicians and patients, the PCO measure/instrument should then be fit for purpose. Subsequent tests of the PCO instrument’s reliability (or repeatability) will be necessary to substantiate it’s robustness, and eventually, a PCO measure that stands to measure the 'real' impact of a treatment on a patient, is derived.