Barriers and facilitators of implementing patient-reported outcome measures in clinical care using the CFIR-ERIC framework

Patient-Reported Outcome Measures (PROMs) are integral tools that capture real-time insights into patients’ experiences. Little is known about barriers and facilitators to PROMs implementation in the Asian context. This study explores the barriers, facilitators, and strategies for implementing PROMs from both patient and provider perspectives. We interviewed 33 patients and 27 healthcare providers from Singapore General Hospital and National University Hospital. Data were analyzed using the Consolidated Framework for Implementation Research (CFIR). The CFIR-Expert Recommendations for Implementing Change (ERIC) matching tool was utilized to match implementation strategies to the identified barriers. All five domains of the CFIR framework were elicited. Facilitators included (1) Improvement in patient-healthcare provider communication, (2) Guidance relating to clinical judgement, (3) Patient empowerment, and (4) Clinician endorsement. Barriers included 1) Lack of local adaptation, (2) Cultural concerns, (3) Lack of coordinated effort, (4) Lack of formal training and (5) Disengaged healthcare workers). In total, 48 ERIC strategies were matched to the corresponding CFIR barriers. Implementing successful and sustainable PROMs requires a multifaceted approach that addresses identified barriers while strategically leveraging facilitators. Future efforts should emphasize PROMs’ value to patients and tailor strategies for diverse populations.