Patient-Centred Assessment of Well-Being: PROMs and PREMs
Knowledge database Technology Human B.3: Hospital @ Home - smooth transition of patients from hospital to home through the use of telemedicine and technologyIn today’s dynamic healthcare landscape, specific forms of patient surveys such as Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) are transforming how health is perceived and evaluated. PROMs and PREMs put the patient’s voice at the centre, making care more personalised. What are their key functions, and how can they be used effectively?
Problem description, research question and relevance
In modern healthcare, patient-centredness is becoming increasingly important. PROMs and PREMs are central tools that support this orientation¹ ².
PROMs capture patients’ subjective health status and quality of life by letting them describe their physical, emotional, and social condition. This subjective insight – directly from patients – goes beyond what clinical measurements can detect and reveals how patients truly feel. Whether related to pain, fatigue, mental health, treatment-specific aspects, or daily functioning, PROMs provide a more comprehensive picture of patients’ quality of life and the impact of health interventions. Within the current shift toward value-based healthcare, PROMs are therefore of growing interest to both providers and insurers³.
PREMs record patients’ reported experiences and opinions regarding the quality of care during treatment. Complementing PREMs, Doctor-Reported Experience Measures (DREMs) are also used to integrate physicians’ experiences into evaluations.
Together, PROMs and PREMs provide a unique perspective on the effectiveness and quality of medical services from the viewpoint of patients themselves. This is especially relevant at a time when healthcare aims not only to optimise clinical outcomes but also to maximise patients’ well-being and satisfaction.
An example of applying these tools is the SHIFT project with the Hospital@Home pilot study (post-hospital care through telemedicine), in which PROMs, PREMs, and DREMs were collected at different points along the treatment pathway.
Methods and procedures in the project
The implementation of PROM and PREM/DREM questionnaires occurs in several steps. First, specific goals and research questions are defined. It is crucial to use validated and reliable questionnaires tailored to the treatment type and patient group.
Standardised PROMs assess general health or address disease-specific aspects⁴. Commonly used PROMs include:
- EQ-5D-5L: Assesses quality of life across five dimensions (mobility, self-care, daily activities, pain/discomfort, anxiety/depression)⁴. Used in the Hospital@Home pilot study.
- SF-36 (Short Form Health Survey): Covers eight health dimensions; often used in chronic disease contexts⁵.
- PROMIS (Patient-Reported Outcomes Measurement Information System): Comprehensive tool measuring physical, mental, and social health across domains⁶.
- QLQ-C30: Cancer-specific questionnaire assessing treatment impact on quality of life⁷.
- HADS (Hospital Anxiety and Depression Scale): Commonly used to screen for anxiety and depression in both outpatient and inpatient settings⁸.
PREM questionnaires are frequently applied in quality development⁹. Their design is project- or application-specific, typically grouped into thematic categories. In the SHIFT Hospital@Home pilot, PREMs included topics such as Overall, Empowerment, Trust, Convenience, Safety.
Surveys can be conducted at different stages of treatment – before, during, and after. To ensure participation, questionnaires should be simple and comprehensible. Increasingly, digital methods such as online surveys are used to facilitate data collection¹⁰.
Results and findings
Applying PROMs and PREMs generates valuable insights. Regular collection often reveals direct correlations between reported outcomes and quality of care. In the SHIFT study, systematic collection of PROM and PREM data during telemedical follow-up enabled tracking of trends and patterns in patient satisfaction and well-being.
For example, PROM data helped monitor patient recovery after discharge and detect negative developments early. PREM data provided insights into the efficiency and humanity of telemedical care. DREM questionnaires complemented this by integrating physicians’ perspectives, enabling a comprehensive assessment of overall care quality.
These data can lead to adaptations in treatment protocols. A notable potential benefit is the identification of issues from both patients’ and physicians’ viewpoints that might otherwise remain unnoticed.
Recommendations for practice
To implement PROMs and PREMs effectively in practice, several recommendations should be considered:
- Validated questionnaires: Use validated and standardised instruments whenever possible.
- Patient-centred approach: Questionnaires and explanations should be clear, understandable, and tailored to the target population.
- Regular collection: Continuous data collection enables tracking of changes and improvements; intervals should balance efficiency with patient burden.
- Integration into workflows: Tools should be seamlessly embedded into existing workflows to minimise administrative burden.
- Staff training: Healthcare professionals should be trained to understand and promote the value of these tools.
- Feedback and adaptation: Insights gained must be regularly used to improve care and align it with patient preferences.
PROMs and PREMs complement traditional clinical metrics and make healthcare more patient-centred and effective. The SHIFT study illustrates how these instruments can be successfully integrated into post-hospital telemedical care.
Literature and other sources
(1) Everything you need to know about PROMs and PREMs. www.remecare.eu/blog/everything-you-need-to-know-about-proms-and-prems (accessed 2025-04-15).
(2) Home. ICHOM. www.ichom.org (accessed 2025-04-22).
(3) Bossart, E.; Glässel, A. PROM („patient-reported outcome measures“) in der onkologischen Nachsorge der Schweiz: Eine SWOT-Analyse aus der Perspektive der Gesundheitsförderung und Prävention. Prävent. Gesundheitsförderung2025. doi.org/10.1007/s11553-024-01193-1.
(4) Neubauer, M. EQ-5D-5L. Heartbeat Medical. heartbeat-med.com/resources/eq-5d-5l/ (accessed 2025-04-15).
(5) Ware, J. E. J. SF-36 Health Survey Update. Spine2000, 25 (24), 3130.
(6) What is PROMIS?. PROMIS Health Organization. www.promishealth.org/57461-2/ (accessed 2025-04-15).
(7) Aaronson, N. K.; Ahmedzai, S.; Bergman, B.; Bullinger, M.; Cull, A.; Duez, N. J.; Filiberti, A.; Flechtner, H.; Fleishman, S. B.; de Haes, J. C. The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument for Use in International Clinical Trials in Oncology. J. Natl. Cancer Inst.1993, 85 (5), 365–376. doi.org/10.1093/jnci/85.5.365.
(8) Stern, A. F. The Hospital Anxiety and Depression Scale. Occup. Med.2014, 64 (5), 393–394. doi.org/10.1093/occmed/kqu024.
(9) Patientenerfahrung - fachübergreifende Informationen. ANQ. www.anq.ch/de/fachbereiche/patientenerfahrung-fachuebergreifende-informationen/ (accessed 2025-04-22).
(10) Bossart, E.; Glässel, A. PROM („patient-reported outcome measures“) in der onkologischen Nachsorge der Schweiz: Eine SWOT-Analyse aus der Perspektive der Gesundheitsförderung und Prävention. Prävent. Gesundheitsförderung2025. doi.org/10.1007/s11553-024-01193-1.