137 Barriers to and enablers of the use of the Otology Questionnaire Amsterdam in clinical practice 7 “In my daily practice, the use of PROMs is not (yet) embedded, it’s just not in my system. You have been doing the profession for a long time, even without OQUA. Then I think, I practiced the profession well in that time, didn’t I?” Table 5 shows all identified enablers of the use of the OQUA as perceived by ENT professionals. Five key enablers are highlighted in Table 5. These enablers are supported by the quote below. “The outcomes are illuminating to me. I’m getting the feedback and that’s is instructive; You’ll see, I closed 10 eardrums and all patients are now suffering from pressure on the ear. It’s clear to me from these answers that I have to change my treatment strategy. We have to learn from our results.” Key barriers and enablers perceived by patients. In Table 6 all barriers as perceived by patients in the use of the OQUA are stated. Four key barriers are highlighted in Table 6. In particular, more than half of the patients reported insufficient feedback on the results of the OQUA in the consultation as a major barrier. They indicated that their motivation could be increased if the outcomes of the OQUA had been clearly named and discussed by the ENT-professional. In the current situation, it was not transparent what results could be achieved with the OQUA and when these results would be evaluated with the patient. Table 6. Identified barriers to the use of the OQUA as perceived by patients COM-B TDF domain Setting* Theme* FRQ CS PS Psychological Capability Knowledge 1,2,3 Lack of knowledge about the objective, content and usefulness of the OQUA 19/25 Yes 3/25 Psychological Capability Memory, attention and decision processes 1,2,3 Experienced challenge in recognizing the importance of the OQUA among large supply of questionnaires 10/25 Yes 1/25 Reflective Motivation Beliefs about consequences 1,2,3 Lack of insight about the relevance of completing the OQUA to the patient as an individual 15/25 No 4/25 Physical Opportunity Environmental context and resources 1,2 Lack of clarity about the questions and structure of the OQUA 6/25 Yes 0/25 Physical Capability Skills 1,2 Lack of skills to interpret the questions of the OQUA, and to report the complaints correctly 6/25 Yes 3/25
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