Use of Patient-Reported Outcome Measures in Athletic Training: Common Measures, Selection Considerations, and Practical Barriers

Abstract

Context Current evidence suggests that a low percentage of athletic trainers (ATs) routinely use patient-reported outcome measures (PROMs). An understanding of the perceptions of ATs who use (AT-USE) and who do not use (AT-NON) PROMs as well as any differences due to demographic characteristics (eg, use for patient care or research, job setting, highest education level) may help facilitate the use of PROMs in athletic training. Objective To describe commonly used PROMs by AT-USE, the criteria by which AT-USE select PROMs, and reasons for non-use by AT-NON. Design Cross-sectional study. Setting Online survey. Patients or Other Participants A convenience sample of 1784 ATs (response rate = 10.7% [1784/17972]; completion rate = 92.2% [1784/1935]) who worked in a variety of settings. Main Outcome Measure(s) Participants completed an anonymous electronic online survey. Descriptive statistics were used to describe commonly used PROMs, PROM selection criteria, and reasons for PROM non-use. Results Participants were classified as AT-USE (n = 370, 20.7%) or AT-NON (n = 1414, 79.3%). For the AT-USE group, the most common type of PROMs used were specific (eg, region, joint; n = 328, 88.6%), followed by single-item (n = 258, 69.7%) and generic (n = 232, 62.7%). Overall, the PROMs most frequently endorsed by the AT-USE group were the Numeric Pain Rating Scale (n = 128, 34.6%); Lower Extremity Functional Scale (n = 108, 29.2%); Disability of the Arm, Shoulder and Hand (n = 96, 25.9%); Owestry Disability Index (n = 80, 21.6%); and Foot and Ankle Ability Measure (n = 78, 21.1%). The most important criteria reported by AT-USE for selecting PROMs were that the measure was valid and reliable, easy for patients to understand, and easy for clinicians to understand and interpret. Common reasons for non-use were that PROMs were too time consuming for the clinician, too time consuming for the patient, and more effort than they were worth. Conclusions The Numeric Pain Rating Scale; Lower Extremity Functional Scale; Disability of the Arm, Shoulder and Hand; Owestry Disability Index; and Foot and Ankle Ability Measure were the PROMs most commonly endorsed by AT-USE and should be considered for athletic training use. To further facilitate the use of PROMs in athletic training, future authors should identify strategies to address organizational and time-constraint obstacles. Interpretation of our study findings may require caution due to a relatively low response rate and because “routine use” was not operationalized.