Psychometric properties and constructs of Patient Reported Experience Measures (PREMs) in primary care: a scoping review

BACKGROUND: Positive patient experience is associated with improved health outcomes and greater adherence to recommended care. Patient-reported experience measures (PREMs) are tools developed to assess these experiences and can be used for multiple purposes, including to inform quality improvement. Patient experience is a complex concept that lacks a standardized definition, with multiple constructs described in the literature. The variety of available PREMs makes it difficult for knowledge users to select those that are valid, reliable, and suitable for their specific practice settings, particularly in primary care. The objective of this scoping review is to identify and describe PREMs developed for the primary care context, the constructs measured and their psychometric properties. METHODS: Following the JBI methodology and PRISMA-ScR guidelines, we conducted a scoping review of studies presenting the development or the psychometric properties of PREMs for adults in primary care in an original or a synthesis design. We searched databases (MEDLINE, CINAHL, Scopus) for studies between January 2019 and December 2023. Two independent reviewers screened and selected studies. They extracted PREMs constructs, psychometric properties, number of items, time of completion and tool availability. RESULTS: Seven studies, including three synthesis designs, were included in the review. From these papers, 23 PREMs were included for data extraction. Tools focusing exclusively on a single component of patient experience, a specific population, or a narrowly defined context were excluded. The constructs most frequently represented across identified tools included accessibility, relational aspects, and quality of clinical care or services. However, no tool covered all relevant constructs, highlighting the variability in defining patient experience. Tools ranged from 4 to 74 items, with limited reporting on completion time. Only five tools involved patients in their development, potentially limiting their applicability in routine practice. Psychometric properties varied, with most tools demonstrating acceptable validity and reliability. However, inconsistencies in reporting and testing methods were noted. CONCLUSION: This review highlights the diversity of PREMs validated for primary care and the variability in their constructs and psychometric properties. Improving conceptual clarity and alignment of patient experience constructs across PREMs, while ensuring meaningful patient involvement in tool development, and rigorous psychometric testing are essential to enhance their utility. This study supports the integration of PREMs into primary care quality improvement initiatives, contributing to more patient-centered healthcare delivery.

• ✓However, inconsistencies in reporting and testing methods were noted.
• ✓CONCLUSION: This review highlights the diversity of PREMs validated for primary care and the variability in their constructs and psychometric properties.
• ✓Improving conceptual clarity and alignment of patient experience constructs across PREMs, while ensuring meaningful patient involvement in tool development, and rigorous psychometric testing are essential to enhance their utility.
• ✓This study supports the integration of PREMs into primary care quality improvement initiatives, contributing to more patient-centered healthcare delivery.