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New Primary Care Outcomes Questionnaire shown to be valuable for primary care research

27 March 2018

The Primary Care Outcomes Questionnaire (PCOQ) developed by researchers at the University of Bristol's Centre for Academic Primary Care has been tested and found to be valid and responsive as an instrument for measuring patient-reported outcomes. The questionnaire has the potential to improve researchers’ ability to measure effectiveness of interventions and may also be useful to GPs for assessing the effectiveness of individual patient care.

Clinicians and researchers often test new configurations of services to improve primary care, for example electronic consultations, health coaching or behavioural therapies. The outcome of these interventions is usually assessed by asking patients to complete a questionnaire before and after the intervention. However, there is currently no Patient Reported Outcome Measure (or PROM) that captures the range of outcomes commonly achieved in primary care from a patient perspective. The PCOQ has been designed to plug that gap, with the overall aim of improving patient care.

The questionnaire, developed with funding from the National Institute for Health Research, is intended for use in research studies to test the effectiveness of interventions in primary care that aim to improve service quality, costs and outcomes.

Although there are questionnaires that are disease-specific and tailored to symptoms or particular conditions, these are of limited value in studies where patients have multiple conditions. The PCOQ has been specifically designed to capture outcomes for patients with more than one health problem, many of whom have long-term conditions. It contains 24 questions in four areas: health and well-being; health knowledge and understanding; confidence in health plan; and confidence in health provision.

The questionnaire was tested by 600 patients in GP practices in the South West of England and the results have been published in the British Journal of General Practice today.

The PCOQ was found to be acceptable, feasible, valid, reliable and responsive (showed change in the patients it was expected to show change in), and measured the outcomes that primary care patients seek and that clinicians can influence.

Dr Mairead Murphy, Senior Research Associate at the Centre for Academic Primary Care and lead author of the study said: “Currently, researchers in primary care do not have an effective tool for measuring patient reported outcomes. Existing questionnaires are either too narrow or too broad in focus and are not designed to capture the full impact of innovations in primary care. Our testing of the PCOQ shows that it has great promise for use in primary care research, which we believe is timely, given the high demand for new interventions in this area.”

Professor Chris Salisbury, co-author of the study said: “The PCOQ was developed to test the benefits of service-level interventions in primary care and, as such, fills an important gap. However, it also has the potential to be used at an individual level, to identify patients’ main concerns in clinical care. One of the next steps for this research is to test if it is useful for patients to complete the PCOQ before a consultation and use it to identify patient problems.” 

For more information about the PCOQ and to register to use it, see the Primary Care Outcomes Questionnaire.

Paper: ‘Primary Care Outcomes Questionnaire: psychometric testing of a new instrument’ by Mairead Murphy, Sandra Hollinghurst, Sean Cowlishaw and Chris Salisbury. Published in British Journal of General Practice. 27 March 2018.

Further information

Related research

  1. Murphy M, Hollinghurst S, Salisbury C. Qualitative assessment of the primary care outcomes questionnaire: a cognitive interview study, BMC Health Services Research 2018, 10.1186/s12913-018-2867-6
  2. Murphy M, Hollinghurst S, Salisbury C. Identification, description and appraisal of generic PROMs for primary care: a systematic review, BMC Family Practice, 2018,
  3. Murphy M, Hollinghurst S, Salisbury C. Agreeing the content of a patient-reported outcome measure for primary care: a Delphi consensus study. Health Expectations, 2016. Doi: 10.1111/hex.12462.
  4. Murphy M, Hollinghurst S, Turner K, Salisbury C. Patient and practitioners' views on the most important outcomes arising from primary care consultations: a qualitative study. BMC Fam Practice 2015;16:108. Doi: 10.1186/s12875-015-0323-9
  5. Murphy M, Salisbury C, Hollinghurst S. Can the outcome of primary care be measured by a Patient Reported Outcome Measure? British Journal of General Practice, 2014;64(629):647-8. doi:10.3399/bjgp14X683017.

About the Centre for Academic Primary Care

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow us on Twitter: @capcbristol.

The research was funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR).

About the NIHR

The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research.

Established by the Department of Health, the NIHR:

• funds high quality research to improve health
• trains and supports health researchers
• provides world-class research facilities
• works with the life sciences industry and charities to benefit all
• involves patients and the public at every step

For further information, visit the NIHR website

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