# Therapists’ and patients’ experiences with electronic patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) before and during treatment in community mental health services: a qualitative study in Norway

## TL;DR

This study explores how therapists and patients in Norway experience using electronic questionnaires to track mental health treatment outcomes and experiences.

## Contribution

The study provides new insights into the barriers and benefits of implementing electronic PROMs and PREMs in community mental healthcare.

## Key findings

- Initial barriers included lack of information and guidance for both therapists and patients.
- Electronic PROMs and PREMs improved patient and therapist awareness of symptoms and treatment needs.
- Successful implementation requires practical guidance and attention to therapist attitudes and skills.

## Abstract

The implementation of electronic patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in community mental healthcare is a complex experience for both therapists and patients. Barriers need to be identified and overcome. The aims of this study were to examine how therapists and patients experienced the implementation of digital PROMs and PREMs in mental healthcare, and to identify those factors that promote positive experiences with mental health treatment supported by PROMs and PREMs.

In this descriptive qualitative study, we conducted focus group interviews with 19 therapists and individual interviews with six patients who had received low-intensity cognitive behavioural therapy interventions. All informants were interviewed about their experiences following the implementation of self-reported electronic measures in an outpatient treatment facility. The central question posed to all informants concerned their experience with electronic questionnaires. The interviews were analysed with a thematic approach using systematic text condensation.

Both therapists and patients experienced initial barriers in the form of a lack of information and guidance about answering questionnaires. Both the therapists and patients experienced improved insight into symptoms and challenges. This enhanced awareness led to the patient being more actively involved in the formulation of objectives in the treatment process. Patients reported that the implementation of PROMs and PREMs led to better informed therapists who listened more actively and asked relevant questions about adherence and current struggles in daily life.

Overall, patients with mental health problems need practical guidance on how to complete self-report questionnaires. By providing their own feedback, patients’ self-awareness of their symptoms and challenges was strengthened, thereby facilitating discussions on how to best align treatment goals to treatment needs. Several patients highlighted the importance for PREMs of the therapists’ attitudes and skills. The findings of this qualitative study suggest that both PROMs and PREMs can be implemented successfully in routine mental healthcare when care is taken to identify and overcome barriers.

The online version contains supplementary material available at 10.1186/s12888-025-07541-5.