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Home Patient Services Patient Services Patient Reported Outcome Measures

Patient Reported Outcome Measures (PROMs)

What are PROMs

Benefits

Completing PROMs

Sample PROMs Questionnaire

NHCS PROMs Initiatives

Case Study

What are PROMs?

Patient Reported Outcome Measures (PROMs) are questionnaires that capture how patients feel about their health, symptoms, daily activities, and quality of life. Unlike clinical tests that measure what healthcare professionals can observe or detect, PROMs capture the patient's own experience of their health and recovery. This helps the multi-disciplinary teams at National Heart Centre Singapore (NHCS) better understand what matters most to each patient and continuously improve the care they provide.

Types of PROMs

Generic PROMs: Focuses on overall health, daily functioning, and quality of life across different patient groups.
Disease-Specific PROMs: Focuses on symptoms and concerns related to a specific medical condition or treatment.

At NHCS, we use both types of PROMs across our cardiac programmes to build a comprehensive understanding of our patients' health and wellbeing.

Benefits of PROMs

PROMs provide valuable insights into patients' symptoms, daily functioning, and quality of life. By understanding health from the patient's perspective, our healthcare teams can better tailor care, monitor progress, and support shared decision-making.

Completing PROMs

When and how PROMs are collected may vary depending on the questionnaire and the clinical programme. Your care team will guide you through the process and answer any questions you may have.

When to complete PROMS?

Patients may be invited to complete a questionnaire at different points during their care - before beginning a programme, at key milestones during it, or upon completion. NHCS care team will inform patients when to expect a questionnaire and what it is for.

How to complete PROMS?

Depending on the programme, PROMs may be completed with a healthcare professional during a clinic visit or phone call, or on your own through an online questionnaire via a secure link.

Sample PROMs Questionnaire

NHCS uses the EQ-5D-5L PROMs to measure health-related quality of life across five dimensions: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Patients rate each dimension and also complete a Visual Analogue Scale (VAS) - a simple 0 to 100 scale where 0 represents the worst health imaginable and 100 represents the best.

These two components give our clinical teams a clear and validated picture of how patients are feeling and functioning at each stage of their care.

View Sample PROMs questionnaire here.

List of PROMs Initiatives in NHCS

NHCS currently uses PROMs across several cardiac programmes to monitor patient outcomes and improve care quality.

Congestive Heart Failure (CHF): Patients are assessed using the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12), a disease-specific measure of heart failure symptoms and their impact on daily life and quality of life.
Heartlander Programme (Heart Failure): Patients recruited under the Heartlander Programme complete three questionnaires - the Integrated Palliative care Outcome Scale (IPOS), the KCCQ-12, and the EQ-5D-5L. These provides a holistic view of physical, emotional, and overall health outcomes.
Cardiac Physiotherapy and Rehabilitation Services: All patients, including those in the Cardiac Rehabilitation programme (including both CHF and post-Coronary Artery Bypass Graft (CABG) patients) and those receiving one-to-one physiotherapy, complete the EQ-5D-5L to measure health-related quality of life before and after their programme.

Case Study

Programme: 8-Week Cardiac Rehabilitation Programme, NHCS
Patient Group: 159 patients following Coronary Artery Bypass Graft (CABG) surgery
Outcome Measure: EQ-5D-5L Index Score and EQ Visual Analogue Scale (VAS)

Background

Coronary Artery Bypass Graft surgery is a major cardiac procedure, and recovery extends well beyond the operating theatre. Structured cardiac rehabilitation plays a critical role in supporting patients' physical recovery, emotional wellbeing, and return to daily life. At NHCS, we use the EQ-5D-5L to measure how patients' health-related quality of life changes over the course of our 8-week Cardiac Rehabilitation Programme, giving us an evidence-based picture of the programme's real-world impact.

What We Measured

Patients completed the EQ-5D-5L questionnaire at the start of the programme and again upon completion, providing a direct before-and-after comparison of their health-related quality of life. Programme completion was defined as attending a minimum of 5 supervised exercise sessions within the 8-week period.

This questionnaire asks patients about five areas of daily life:

How well they can move around
How well they can look after themselves
How well they can do their usual activities
Whether they are in pain or discomfort
Whether they feel worried or anxious

Patients also gave their health an overall score out of 100, where 0 means feeling as unwell as possible and 100 means feeling in the best health possible.

What Our Patients Reported

After completing the 8-week programme, patients reported feeling significantly better across all areas.

Overall health score

Before the programme, patients reported an average health score of about 69 out of 100. After completing the programme, the health score rose to about 83 out of 100. Patients felt noticeably healthier and better in themselves after rehabilitation.

Quality of life score

Patients also showed a meaningful improvement in their overall quality of life score, rising from 0.91 to 0.97 on a scale where 1.0 represents full health. In simple terms, patients felt much closer to their best possible health after completing the programme.

What This Means

These results demonstrate that structured cardiac rehabilitation at NHCS is associated with clinically meaningful improvements in how post-CABG patients feel and function in their daily lives. The large effect size observed in self-rated health is particularly notable, reflecting the substantial patient-reported benefit of programme participation.

The findings also underscore the importance of exercise prescription and programme adherence. Patients who committed to completing the programme reported feeling significantly better, both in terms of measurable quality of life and their own overall sense of health.