Patient reported outcome measures in cardiovascular disease

ESC CardioMed ◽  
2018 ◽  
pp. 1399-1402
Author(s):  
Ran Kornowski ◽  
Eli I. Lev
Keyword(s):  
Coronary Revascularization ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Clinical Encounter ◽  
Normal Function ◽  
Response To Treatment ◽  
Cardiac Events ◽  
Clinical Workflow ◽  
Patient Reported ◽  
Revascularization Procedures

The patient reported outcome measure (PROM) initiative focuses on what matters to patients following medical interventions, a perspective that is often ignored or missed by the treating physicians. PROM questionnaires encompass what occurs outside the clinical encounter, such as symptom severity, the response to treatment, undesirable side effects, returning to normal function, perceived needs, and what really matters to patients in their ordinary environment. This topic is of prime importance in cardiovascular medicine, as it encompasses chronic diseases with exacerbation and various cardiac interventions. PROMs and quality of life questionnaires have been utilized mostly in congestive heart failure syndromes and following surgical and catheter-based coronary revascularization procedures. Improved scores influenced by age or sex have been obtained following revascularization procedures. Poor PROMs are specifically related to subsequent cardiac events and all-cause mortality. Some hurdles challenging the routine use of PROMs include the feasibility of implementation into the clinical workflow and getting medical staff engaged in the project. Overcoming these challenges may enable significant improvement in patient care and patient-centred cardiovascular outcomes.

scholarly journals Plasma Fibrinogen Along with Patient-reported Outcome Measures Enhances Management of Polymyalgia Rheumatica: A Prospective Study

2014 ◽  
Vol 41 (5) ◽  
pp. 931-937 ◽  
Author(s):  
Eoghan M. McCarthy ◽  
Paul A. MacMullan ◽  
Shibeb Al-Mudhaffer ◽  
Anne Madigan ◽  
Suzanne Donnelly ◽  
...  
Keyword(s):  
Disease Activity ◽  
Polymyalgia Rheumatica ◽  
Health Assessment ◽  
Correlation Coefficients ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Plasma Fibrinogen ◽  
Response To Treatment ◽  
Receiver Operating Curve ◽  
Patient Reported

Objective.We sought to prospectively examine the responsiveness of a number of patient-reported outcome (PRO) measures in polymyalgia rheumatica (PMR), as well as their relationship to the biomarkers erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and plasma fibrinogen.Methods.Sixty patients with PMR were divided into active (n = 25) or inactive (n = 35) disease groups based on symptoms; physician assessment; and the biomarkers ESR, CRP, and plasma fibrinogen. Groups underwent assessment at baseline and 6 weeks. Disease activity measures and relevant PRO measures were recorded. Measures of responsiveness were compared for all PRO and biomarkers.Results.Visual analog scale disease activity (VASDA) and VAS quality of life (VASQOL) are more responsive to change in disease activity than VAS pain, morning stiffness, Health Assessment Questionnaire (HAQ), and PMR-activity score (AS). Analysis of PMR-AS versus VASDA, VASQOL, and HAQ showed correlation coefficients of 0.87 (p < 0.001), 0.80 (p < 0.001), and 0.68 (p < 0.001), respectively. Receiver-operating curve (ROC) analysis revealed VASDA to be more specific than either HAQ (0.95 vs 0.85; p < 0.001) or VASQOL (0.95 vs 0.93; p < 0.001) for the detection of response to treatment in active PMR. Overall, fibrinogen showed superior correlation coefficients with the various PRO than either of the standard biomarkers ESR or CRP. In addition, standardized response means for fibrinogen, ESR, and CRP were 1.63, 1.2, and 1.05, respectively, indicating that plasma fibrinogen was the most responsive biomarker for assessment of change in disease activity.Conclusion.VASDA and VASQOL are the most responsive PRO to changes in disease activity in PMR. In addition, plasma fibrinogen demonstrated greater responsiveness to changes in disease activity and superior correlation with the various PRO measures recorded than did the standard biomarkers ESR and CRP.

scholarly journals From obligation to opportunity: future of patient-reported outcome measures at the Veterans Health Administration

2019 ◽  
Vol 9 (6) ◽  
pp. 1157-1162
Author(s):  
Theresa M Coles ◽  
Sarah M Wilson ◽  
Bo Kim ◽  
Jean C Beckham ◽  
Warren A Kinghorn
Keyword(s):  
Outcome Measures ◽  
Veterans Health Administration ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Clinical Encounter ◽  
Veterans Health ◽  
Health Administration ◽  
Improve Patient Satisfaction ◽  
Patient Reported ◽  
Improve Patient

When implemented systematically and longitudinally outside of the clinical encounter, patient-reported outcome measures may bolster the therapeutic alliance, enable new opportunities for clinician-patient communication, and improve patient satisfaction and clinical outcomes.

scholarly journals Characterising and quantifying outcomes in rhinology out-patients: measurements in the ‘real world’

2010 ◽  
Vol 124 (11) ◽  
pp. 1172-1177 ◽  
Author(s):  
J C L Yeo ◽  
O J Hilmi ◽  
G W McGarry
Keyword(s):  
Chronic Rhinosinusitis ◽  
Patient Population ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Medical Intervention ◽  
Outcome Data ◽  
Clinical Findings ◽  
Response To Treatment ◽  
Anatomical Anomaly ◽  
Patient Reported

AbstractAims:We aimed to evaluate a practical, computerised database for collection of patient-reported and clinical outcome data, introduced as a means of characterising our patient population and assessing the effect of our interventions.Methods:A prospectively updated, computerised database was used to detail each patient's coded and structured diagnosis and clinical findings. Response to treatment was recorded using the Sino-Nasal Outcome Test 22 and changes in graded clinical examination findings.Results:Data for 770 patients were prospectively entered into the database. Patients were grouped diagnostically as follows: rhinitis (20.4 per cent), chronic rhinosinusitis (12.2 per cent), chronic rhinosinusitis with polyps (24.7 per cent), anatomical anomaly (22.7 per cent), epistaxis (3.4 per cent) and ‘other’ (18.4 per cent). Following initial medical intervention, the greatest improvement in the Sino-Nasal Outcome Test 22 score was seen in the chronic rhinosinusitis with polyps group (−11.3), followed by the rhinitis group (−6.1) and the chronic rhinosinusitis group (−5.4).Conclusions:The tested rhinology database provides a simple, effective and practical tool for integrating the recording of clinical and patient-reported outcome measures during the out-patient visit. It enables characterisation of the patient population, and accurately monitors and records treatment responses.

PROMsBase: Web-based repository portal for patient-reported outcome measures in orthopaedics

2017 ◽  
Vol 25 (3) ◽  
pp. 867-877 ◽  
Author(s):  
Oren Tirosh ◽  
Phong Tran ◽  
Jesse Renouf ◽  
Nicholas Pergaminelis ◽  
Christa Noelle Purdie ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Routine Practice ◽  
Clinical Workflow ◽  
Web Based ◽  
Post Surgery ◽  
Patient Reported ◽  
Questionnaire Online

Patient-reported outcome measures lead to better communication and decision-making between clinicians and patients. Applying a web-based repository system for data collection was previously suggested, but such system is not available. This article introduces the development and implementation of a new web-based application, PROMsBase, in orthopaedics clinical practice. PROMsBase was developed using a web interface, allows access using both desktop and mobile devices. Between 2013 and 2016, a total of 3192 pre-surgery questionnaires were collected. In total, 238 patients completed their post-surgery questionnaire online from home. PROMsBase was well embedded into routine practice without disrupting clinical workflow and overloading clinicians’ and researchers’ workload. Tablets were not more useful and only 37 per cent of the patients completed the questionnaire online. PROMsBase provided a platform to easily collect and store data in clinical practice. If properly integrated, this could promote better care and communication between providers and patients.

scholarly journals Patient-reported outcome measures in the care of in-centre hemodialysis patients

2021 ◽  
Vol 5 (S2) ◽  
Author(s):  
Sara N. Davison ◽  
Scott Klarenbach ◽  
Braden Manns ◽  
Kara Schnick-Makaroff ◽  
Robert Buzinski ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Outcome Measures ◽  
Symptom Burden ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Clinical Workflow ◽  
Level Of Functioning ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

AbstractKidney failure requiring dialysis is associated with high symptom burden and low health-related quality of life (HRQL). Patient-reported outcome measures (PROMs) are standardized instruments that capture patients’ symptom burden, level of functioning, and HRQL. The routine use of PROMs can be used to monitor aspects of patients’ health that may otherwise be overlooked, inform care planning, and facilitate the introduction of treatments. Incorporating PROMs into clinical practice is an appropriate strategy to engage patients and enhance their role in decisions regarding their care and outcomes. However, the implementation of PROMs measurement and associated interventions can be challenging given the nature of clinical practice in busy hemodialysis units, the variations in organization and clinical workflow across units, as well as regional programs. Implementing PROMs and linking these with actionable treatment aids to alleviate bothersome symptoms and improve patients’ wellbeing is key to improving patients’ health. Other considerations in implementing PROMs within a hemodialysis setting include integration into electronic medical records, purchase and configuration of electronic tools (i.e., tablets), storage and disinfection of such tools, and ongoing IT resources. It is important to train clinicians on the practical elements of using PROMs, however there is also a need to engage clinicians to use PROMs on an ongoing basis. This article describes how PROMs have been implemented at in-centre hemodialysis units in Alberta, Canada, addressing each of these elements.

Optimizing electronic capture of patient-reported outcome measures in oncology clinical trials: lessons learned from a qualitative study

2020 ◽  
Vol 9 (17) ◽  
pp. 1195-1204
Author(s):  
Florence D Mowlem ◽  
Brad Sanderson ◽  
Jill V Platko ◽  
Bill Byrom
Keyword(s):  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Patient Reported ◽  
Oncology Clinical Trials ◽  
Anticancer Treatment ◽  
Fit For Purpose ◽  
The Impact ◽  
Electronic Implementation

Aim: To understand the impact of anticancer treatment on oncology patients’ ability to use electronic solutions for completing patient-reported outcomes (ePRO). Materials & methods: Semi-structured interviews were conducted with seven individuals who had experienced a cancer diagnosis and treatment. Results: Participants reported that the following would impact the ability to interact with an ePRO solution: peripheral neuropathy of the hands (4/7), fatigue and/or concentration and memory issues (6/7), where they are in a treatment cycle (5/7). Approaches to improve usability included: larger, well-spaced buttons to deal with finger numbness, the ability to pause a survey and complete at a later point and presenting the recall period with every question to reduce reliance on memory. Conclusion: Symptoms associated with cancers and anticancer treatments can impact the use of technologies. The recommendations for optimizing the electronic implementation of patient-reported outcome instruments in this population provides the potential to improve data quality in oncology trials and places patient needs at the forefront to ensure ‘fit-for-purpose’ solutions.

Impact of Depression on Patient-Reported Outcome Measures After Lumbar Spine Decompression

Spine ◽  
2018 ◽  
Vol 43 (6) ◽  
pp. 434-439 ◽  
Author(s):  
Robert K. Merrill ◽  
Lukas P. Zebala ◽  
Colleen Peters ◽  
Sheeraz A. Qureshi ◽  
Steven J. McAnany
Keyword(s):  
Lumbar Spine ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported

scholarly journals The effects of competition and bundled payment on patient reported outcome measures after hip replacement surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanny Goude ◽  
Sverre A. C. Kittelsen ◽  
Henrik Malchau ◽  
Maziar Mohaddes ◽  
Clas Rehnberg
Keyword(s):  
Hip Replacement ◽  
Health Gain ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Economic Incentives ◽  
Bundled Payment ◽  
Treatment Groups ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Patient Reported

Abstract Background Competition-promoting reforms and economic incentives are increasingly being introduced worldwide to improve the performance of healthcare delivery. This study considers such a reform which was initiated in 2009 for elective hip replacement surgery in Stockholm, Sweden. The reform involved patient choice of provider, free establishment of new providers and a bundled payment model. The study aimed to examine its effects on hip replacement surgery quality as captured by patient reported outcome measures (PROMs) of health gain (as indicated by the EQ-5D index and a visual analogue scale (VAS)), pain reduction (VAS) and patient satisfaction (VAS) one and six years after the surgery. Methods Using patient-level data collected from multiple national registers, we applied a quasi-experimental research design. Data were collected for elective primary total hip replacements that were carried out between 2008 and 2012, and contain information on patient demography, the surgery and PROMs at baseline and at one- and six-years follow-up. In total, 36,627 observations were included in the analysis. First, entropy balancing was applied in order to reduce differences in observable characteristics between treatment groups. Second, difference-in-difference analyses were conducted to eliminate unobserved time-invariant differences between treatment groups and to estimate the causal treatment effects. Results The entropy balancing was successful in creating balance in all covariates between treatment groups. No significant effects of the reform were found on any of the included PROMs at one- and six-years follow-up. The sensitivity analyses showed that the results were robust. Conclusions Competition and bundled payment had no effects on the quality of hip replacement surgery as captured by post-surgery PROMs of health gain, pain reduction and patient satisfaction. The study provides important insights to the limited knowledge on the effects of competition and economic incentives on PROMs.

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