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MYMOP2

See the MYMOP2: Link to the measure's 'initial form' and 'follow up form'

Description
The MYMOP2 (Make Yourself Medical Outcome Profile version 2) is a patient-generated problem-specific measure that allows the patient to select the most important problems to them that they want to address. It is a free to use, clinically useful measure.

During a consultation with your patient, the patient should be asked to complete the MYMOP with you. The patient decides what symptom is most problematic to them (they can also suggest a related secondary symptom) and they rate the severity of this symptom. They then decide on an activity that they would like to improve on (this can be something that seems quite minor, like brushing their hair or being able to put on their socks, or it can be something ‘bigger’) and they rate how much the symptom impedes them in this activity. The patient also rates their general wellbeing and notes down any medications that they are on for the symptom, including doses. A follow up at an agreed time period is carried out and the change in scores and medication doses/use is examined. It is important to use unmodified versions of the MYMOP2 forms for validity and reliability reasons.

Through using the MYMOP2 you are not only finding out about the effectiveness of your treatment, but you are also acting in a patient centred way addressing the issues that are most important to your patient and allowing them to set their own treatment goals.

The MYMOP2 can be used in patients from 11 years and older. While it has not been validated for younger children, the author (via the official website, see ‘relevant links’ below) does indicate that the MYMOP2 can be completed with the help of a carer, parent or guardian. The same person should also help with the follow up.

How to collect the data
The MYMOP website has a very clear set of user guidelines and forms are available here.

The MYMOP2 is a two stage process. The first MYMOP2 form should be completed with your patient during a consultation with the patient.

Stage 1:

  • With a copy of the MYMOP2 initial form at hand, ask the patient to tell you what symptom is mot important to them that they have attended treatment for. If the patient is unsure about what you mean by ‘symptom’ you can give an example, but it is important that this is in the patient’s own words. This should only be one symptom (so ‘pain’ instead of ‘pain and tingling’). Write the symptom onto the form for them.
  • You can then ask them for a second symptom. This must be related to the first one (so in the example above it could be ‘tingling’). Symptom 2 is optional, but encouraged. Write the symptom onto the form.
  • Ask the patient to choose an activity that they feel the symptom(s) interfere with. This should be something that the person considers important. Encourage them that it can be something that seems quite ‘minor’ like brushing their hair or doing some garden work. Again, this is optional, but strongly encouraged. Write this down on the form.
  • Ask them to rate on a 0-6 scale (6=as bad as it can be) how bad each of these three items have been over the last week.
  • Ask them “Lastly how would you rate your general feeling of wellbeing during the last week?” in those words on the 0-6 scale (you can clarify what well-being means to them if you need to).
  • Get them to complete the section about medications.

Stage 2:

  • After an agreed time period (this should be a sensible, meaningful time period) or after a treatment or intervention you should use the follow up form. This can be posted to the patient or completed with them during a consultation. The original symptoms and activities should be written onto the form in the same wording as before. A third symptom option (not required) is available if a new, related, important symptom has arisen.
  • The patient should rate on the 0-6 scale for the symptoms, activity and wellbeing and should complete the medication questions as before.

If the patient has two different problems (e.g., asthma and knee pain) you can complete two MYMOP2 forms and measure both, if you wish. Alternatively you can measure the MYMOP2 on only one problem at a time, to keep things simpler.

After the follow up stage you should calculate your scores and discuss these changes with your patient to establish progress and any further needs.

How much data do you need to collect?
You can either collect data from only one patient to use this completely as an individualised clinical tool or you can use the MYMOP2 to look at the effectiveness of your treatments overall with a group of patients. Due to the flexibility of the measure no strict guidance on how many measures you should collect are given. However, a representative sample of your patients should be used. In general, the greater the number of measures collected the better and more meaningful your generalisations will be. A sample of around 50 should be adequate, but fewer will still provide meaningful. And regardless of the total number of measures collected, each individual measure is still very meaningful clinically to your individual patient.

What to do with your raw data – scoring the measure
Symptom 1, Symptom 2, Activity, and Wellbeing each have a separate score (from 0 ‘as good as it could be’ to 6 ‘as bad as it could be’).

You can also work out a MYMOP profile score. The MYMOP profile score is the mean average of all answered questions. Example: If symptom 1 is scored as 6, Symptom 2 is not used, Activity is scored as 4, and Wellbeing is scored as 2, you would sum these scores and divide them by the number of questions included.

  • So, 6+4+2=12 (the summed score), then divide this by 3 (the number of questions)
  • You then have a MYMOP profile score of 4.

This should be worked out for both your initial and follow up forms. It is the change in the scores that is of interest when using this measure.

You can include Symptom 3 in your calculations if it has been included in the follow up form.

To use the MYMOP2 in a meaningful way, you should look at not only the MYMOP profile score change, but also the change in the individual items (the Symptoms, Activity, and Wellbeing scores).

The official MYMOP website has a template spreadsheet that will help you to calculate these scores more easily. This can be found on the FAQ page here, under the question ‘How should I present the changes in MYMOP scores?’

Interpreting your findings
Normative values are neither available nor meaningful for this measure, as it is individual to each patient. What you should be interested in is the change in their scores from the initial forma to the follow up form. You should consider these for each individual patient to use in a clinically meaningful way. You can also consider your overall effectiveness if you have collected MYMOP2 data from more than one patient.

To determine if any meaningful change has occurred you are looking for a change in the scores of more than 1. The higher the score, the worse it is (remember, 6= as bad as it can be). So, any change of 1 or more that has seen an increased score on the question/MYMOP profile in the follow up represents a worsening. Any change that lowers the score on a question/MYMOP profile by 1 or more represents an improvement.

You can also consider the medication information – has the patients use of any medications changed? Again, logically a decrease would represent a good change and an increase would recommend a bad change. Remember though, that changes in medications may be for reasons other than the course of action/intervention that you have taken (indeed, an increase in medication may be the reason for improvement), so this section must be interpreted with caution.

Reporting your finding
See also Stage 5: Reporting Outcomes

You should report the MYMOP profile score and the Symptom, Activity and wellbeing scores for both your initial form and the follow up form. The MYMOP profile score will give you an overall picture of any changes and the Symptom, Activity and Wellbeing scores will give you clinically useful information. It may be easiest to present these either in a table or in a clustered bar chart. Below are examples of what this may look like:

Table example:

MYMOP scores

 

Initial MYMOP form

(mean)

Follow-up

MYMOP Form

(mean)

Change in score

(mean)

Symptom 1

Mean score

Mean score

Difference

Symptom 2

Mean score

Mean score

Difference

Activity

Mean score

Mean score

Difference

Wellbeing

Mean score

Mean score

Difference

MYMOP profile

Mean score

Mean score

Difference

Clustered bar chart example: 

example graph

Whichever way you choose to present your findings, remember that you are looking for a difference of 1 between the initial and follow up scores to find a meaningful change. In addition to presenting your graph or table, you should include a short written explanation. You can also comment on the medication question if you feel it is relevant.

We have included a rough template below to get you started. This is not the whole story, however, just a small part of it. You should still continue on to Stages 5 and 6 to best report your findings and to move onto the next stages (e.g., acting on your findings).

Template
The MYMOP2 (Make Yourself Medical Outcome Profile version 2) was used to determine the effectiveness of the treatment *_you can be more specific here_*. The MYMOP2 allows patients to choose and address the symptoms that are most important to them, choose an activity that they would like to be able to do better but can’t as a result of the symptoms and rate their overall wellbeing. The MYMOP2 has an initial assessment and a follow-up assessment. The follow up assessment was give *_time-span_* after the initial assessment. Below is a graph/table of the findings, detailing the changes. A difference of ‘1’ represents a meaningful change. The MYMOP2 scales range from 0-6. Higher values represent the worst outcome and lower scores represent the best outcome.

*_put graph or table here_*

As shown in the graph/table, meaningful changes were found in the patients’ experiences of Symptom 1/Symptom 2/Activity/Wellbeing. Improvement was found for Symptom 1/Symptom 2/Activity/Wellbeing. Scores for Symptom 1/Symptom 2/Activity/Wellbeing were found to be poorer/unchanged after the treatment. These findings indicate that the treatment was/was not/was partially successful. The MYMOP profile score represents the overall experience for the patient. As shown, this score was higher/lower/the same after treatment, indicating success/lack of success with the treatment. *_say what this means – e.g., do you need to change the treatment you are giving patients; is a change in practice required; is everything fine?_*

The MYMOP2 also asks patients about the importance of reducing medication and about the doses of medication that they are on. *___%_* of patients indicated that cutting down medication was very important to them and *___%_* were successful in reduction or cessation. This indicates some success with the treatment.

Relevant Publications
MYMOP publications page

Relevant links
Official MYMOP page with links to scoring information and the MYMOP forms

FAQ page for MYMOP2 containing links to example data tables and an example spreadsheet to help you calculate your MYMOP2 scores

Copyright/Intellectual property rights
To use the MYMOP is free. However, you should register with the author of the measure (Dr. Charlotte Paterson) to use it here.


You have reached the end of the guidance for this measure.  Move onto Stage 5: Reporting Outcomes

Or go back to Stage 3: Considering Options to review other measures.

 

© Copyright 2012 NMAHP RU, Stirling University