UK Validation of the First Vascular Surgery Patient Reported Experience Measure (PREM): the PREMIERE Study.

Abstract

The aim of this study was to psychometrically validate a vascular surgery specific Patient Reported Experience Measure (PREM). The PREM was developed through a multiphase process involving systematic review, qualitative multicentre validation study within a multiphase instrument development programme, patient interviews, and healthcare professional focus groups. The present study reports its validation across three UK vascular units. Psychometric evaluation followed COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance, assessing item reduction, factor structure, internal consistency (Cronbach's α), construct validity, feasibility, and acceptability. A total of 240 patients completed the PREM (mean age 69.1 years; 61.3% men). The 22 item instrument was reduced to 14 items following psychometric evaluation. Feasibility was high, with > 95% item completion for 12 of 14 items, mean completion time of 7 minutes, and 82.1% of questionnaires completed independently. Exploratory factor analysis supported a five domain structure, explaining 58.6% of the variance : information and communication, shared decision making, access and timeliness, in patient support and overall experience, and discharge and follow up. Internal consistency was acceptable across domains (α = 0.70 - 0.78) and for the overall scale (α = 0.71). PREM scores were lower with longer hospital stay (r = -0.36, p < .01) and emergency admission (r = -0.15, p = .032), and higher with increasing time since discharge (r = .14, p = .041). Key predictors of overall satisfaction included communication, staff availability, timeliness, pain management information, and emotional support. This vascular specific PREM is a concise, reliable, and valid instrument, feasible for routine use and sensitive to clinically meaningful variation, supporting patient centred evaluation of vascular services.