PREM-C9© (Patient-Reported Experience Measure for COPD) is a 9-item questionnaire designed to measure patients’ experience of living with chronic obstructive pulmonary disease (COPD) and the care they receive. It captures aspects of daily life with COPD, interactions with healthcare providers, and experiences during exacerbations.

What PREM-C9 Measures

PREM-C9 evaluates three main areas:

  1. Everyday life with COPD
  2. Usual care and interactions with healthcare services
  3. Experiences during COPD exacerbations

Evidence Supporting PREM-C9©

Development and Content Validity

The instrument was developed from qualitative interviews with COPD patients exploring their experiences with diagnosis, healthcare, and daily life with COPD. These interviews identified major themes and generated an initial pool of candidate questions that were later refined into the final 9-item tool.

Psychometric Validation

The first validation study used Rasch analysis and psychometric testing to refine and validate the questionnaire. Results showed good measurement properties and meaningful correlations with established COPD measures such as the COPD Assessment Test (CAT) and the Hospital Anxiety and Depression Scale (HADS). The instrument also showed evidence of responsiveness to change following pulmonary rehabilitation.

Cross-Cultural Validation

PREM-C9 has been translated and validated in multiple languages including Spanish, Catalan, and Polish. Studies have demonstrated good internal consistency and structural validity, supporting its use in different healthcare systems and cultural settings.

Research and Clinical Applications

PREM-C9 is used to evaluate patient experience of COPD care, support quality improvement programs, and assess outcomes of interventions such as pulmonary rehabilitation. It complements clinical outcomes and quality-of-life measures by capturing the patient perspective.

Key Takeaway

PREM-C9© is a validated COPD-specific patient-reported experience measure that helps clinicians, researchers, and healthcare organizations better understand how patients experience COPD and the care they receive.

PREM-C9 Governance Board

  • Matthew Hodson RN, PhD — Chief Nursing Officer, Royal Papworth Hospital NHS Foundation Trust, UK (Developer)
  • Prof. Janelle Yorke RN, MRes, PhD — Chair Professor of Nursing, Head of School of Nursing, The Hong Kong Polytechnic University, Hunghom, Hong Kong, China SAR (Developer)
  • Prof. Paul W Jones, MD — GAAPP Senior Research Physician (Consultant); Professor Emeritus, City St George’s, University of London, UK (Developer)
  • Shannon Sibbald, PhD — Associate Professor, Graduate Chair, Health and Rehabilitation Sciences Program, School of Health Studies, Faculty of Health Sciences; Department of Family Medicine and the Schulich Interfaculty Program in Public Health; Schulich School of Medicine and Dentistry, Western University, Canada
  • Ruth Tal-Singer, RN, PhD — Board Operations, Chief Scientific Officer (Consultant), GAAPP, Vienna, Austria

Available Translations

English
Portuguese

References

  1. Walker S, Andrew S, Hodson M, Roberts CM. Stage 1 development of a patient-reported experience measure (PREM) for chronic obstructive pulmonary disease (COPD). NPJ Prim Care Respir Med. 2017;27(1):47. doi:10.1038/s41533-017-0047-5
  2. Hodson M, Roberts CM, Andrew S, Graham L, Jones PW, Yorke J. Development and first validation of a patient-reported experience measure in chronic obstructive pulmonary disease (PREM-C9). Thorax. 2019;74(6):600–603. doi:10.1136/thoraxjnl-2018-211732
  3. Moharra M, Bayés B, Llupià A, Almazán C. Cross-cultural adaptation and face validity of the PREM-C9 version of the patient-reported experience measure in patients with chronic obstructive pulmonary disease. XPA Health Communication. 2021;4(1).
  4. Moharra M, Llupià A, Bayés B, Escarrabill J, Almazán C. Translation and validation of the COPD patient-reported experience measure (PREM-C9) in Spanish and Catalan. NPJ Prim Care Respir Med. 2024;34(1):31. doi:10.1038/s41533-024-00393-8
  5. Damps-Konstańska I, Ciećko W, Jassem E, et al. Polish adaptation and psychometric validation of the PREM-C9 questionnaire for patients with chronic obstructive pulmonary disease. Healthcare (Basel). 2023;11(20):2746. doi:10.3390/healthcare11202746
  6. Jones MA, et al. Measuring the experience of living with COPD and receiving medical care in people with COPD. European Respiratory Journal. 2020;56(Suppl 64):956.
  7. Mandizha J, Crook C, Lanario J, et al. Patient-reported experience measure (PREM) for patients with interstitial lung disease (ILD): modification of a pre-existing measure. BMJ Open Respir Res. 2026;13(1):e003330. doi:10.1136/bmjresp-2025-003330
  8. Zibrowski E, Islami F, Kellar A, Licskai C, Ferrone M, Sibbald SL. Validation of a COPD patient-reported experience measure (PREM-C9) in Ontario, Canada. Journal of Patient Experience. 2026;13(1). Available at: https://pxjournal.org/journal/vol13/iss1/