Physiotherapist and nurse perspectives on the acceptability and timing of patient-reported outcome measures in clinical practice:Balancing standardisation and flexibility

Purpose<br/>Patient-reported outcome measures (PROMs), when used at the point-of-care, provide a mechanism for systematically integrating patients' voices into shared decision-making. We examined clinicians’ perspectives on the acceptability and preferred timing of PROM completion in routine clinical care for respiratory, musculoskeletal, heart, kidney and/or diabetic chronic conditions. <br/><br/>Methods<br/>Semi-structured interviews were conducted over videoconference between October 2024 and May 2025. Participants worked at various New South Wales Health clinics, providing care for patients with chronic conditions, and were eligible to collect and review patient-reported measures digitally using the Health Outcomes Patient Experience platform (NSW PRMs-HOPE program). Reflexive thematic analysis was undertaken. <br/><br/>Results<br/>Twenty-two physiotherapists and nursing professionals were interviewed. Acceptability themes included: 1) purpose of PROMs; 2) broader ethical considerations for PROMs collection and use; 3) practical aspects of PROM administration. Findings highlighted the elusiveness of an “ideal” timing for PROMs. Timing themes included: 1) (mis)alignment in timing of PROM administration; 2) preferences for fixed or customised timing and frequency of administration; 3) temporal fit and workflow alignment. <br/><br/>Conclusion<br/>PROMs were reported as most acceptable when their selection, content, and timing aligned with clinical purpose, scope of practice, and existing workflows. Flexibility in PROM administration was perceived to enhance relevance at the point of care and support timely, condition-specific clinical conversations and interventions. However, clinicians also recognised that increased flexibility may reduce the comparability of aggregated PROM data across cohorts, highlighting an inherent acceptability trade-off between meeting individual clinical needs and supporting system-level performance monitoring and benchmarking.<br/><br/>Patient or Public Contribution<br/>BR and MF, consumer advisors in the PROM-PATH research program, were instrumental in shaping the study design, recruitment materials, and clinician interview guide to ensure relevance and inclusivity. They were trained in qualitative research methods by JN, contributing to monthly analysis meetings, interpreting transcripts, refining coding, and developing themes that reflected their lived experience. During dissemination, they co-authored abstracts, developed presentation materials and presented at conferences alongside JN.<br/><br/><br/>Plain Language Summary<br/>People with long‑term health conditions can fill out health surveys called patient‑reported outcome measures (PROMs). These health surveys help patients share how they are feeling in their own words. PROMs are used more in healthcare now, but we do not know enough about how clinicians feel about using them or when they should be given to patients.<br/>In this study, we spoke with physiotherapists and nurses who use PROMs in their daily work. They told us what they think about PROMs and when these should be completed.<br/>Clinicians said PROMs can help them better understand patients, detect changes in health, and support conversations about care. But they also found some parts difficult, such as needing extra time, unclear questions, language and cultural barriers, and not always knowing how to use the results during appointments.<br/>Overall, clinicians wanted more choice in which PROMs they use and when patients complete them. They felt this would make PROMs more useful for patient care. But, too much flexibility could make it harder to compare results across clinics and to see how well services are looking after people.<br/>