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COPD: PREMs development work & feasibility report

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Patient Reported Experience Measures (PREMs) are a key feature on the Government healthcare agenda. PREMs can provide important evidence regarding clinical care from the patient perspective. In conjunction with organisational and clinical audit data, they provide a rounded view of a patient’s care experience and support the development of quality improvements.

As part of the national COPD audit programme, one year of development work for the future incorporation of PREMs into the audit programme was commissioned; to inform decisions regarding future roll-out of this element and associated funding.

Key recommendations

  • Summary of key Lessons Learned
    • Relatively little work has looked specifically at the requirements of people with COPD or at how people’s COPD specific experiences should be measured.
    • In planning and conducting the pilot survey, many key findings and learning points related to the practicalities of getting the survey to the patient; these are not trivial when considering the potential integration of PREMs to a national audit programme.
    • The use of an online survey approach appears attractive due to the elimination of printing, postage, and data entry costs, but was negatively received by patients and NHS providers alike.
    • Postal methodologies proved superior to hand-out (in terms of response rates) in secondary care and pulmonary rehabilitation settings. Similar response rates were achieved from these two methods in primary care but from an administrative point of view a postal approach is favourable as it would reduce burden at practice level. Where practices needed to be directly involved in the survey administration proved to be a significant barrier to participation.
    • A prospective hand-out approach posed challenges in identifying eligible patients at the point of care, making appropriate exclusions, and determining an appropriate length of fieldwork. A postal survey would be easier to standardise in the event of a wider rollout.
    • Although devolution of some aspects of survey implementation was not as great a barrier in secondary care and pulmonary rehabilitation, the cost to the service of a devolved approach (in terms of local staff time and resource) would likely exceed the cost of centralised administration. Centralised administration would also enable assurance about consistency of methods and particularly about patient inclusion/exclusion from samples.

Who's involved


  • Anglia Ruskin University
  • British Lung Foundation
  • PICKER Institute Europe
  • Homerton University Hospital NHS Foundation Trust
  • St George’s University of London
  • British Lung Foundation
  • British Thoracic Society
  • British Thoracic Society
  • British Lung Foundation