scholarly journals Clinical events and patient-reported outcome measures during CKD progression: findings from the CRIC study

2020 ◽  
Author(s):  
Morgan E Grams ◽  
Aditya Surapaneni ◽  
Lawrence J Appel ◽  
James P Lash ◽  
Jesse Hsu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Kidney Disease ◽  
Kidney Function ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Clinical Events ◽  
Ckd Stage ◽  
Patient Reported ◽  
Egfr Decline

Abstract Background Patients with chronic kidney disease (CKD) face risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and death, but also decline in kidney function, quality of life (QOL), and mental and physical well-being. This study describes the multidimensional trajectories of CKD using clinical events, kidney function, and patient-reported outcome measures. We hypothesized that more advanced CKD stages would associate with more rapid decline in each outcome. Methods Among 3,939 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, we evaluated multidimensional disease trajectories by G- and A-stages of enrollment eGFR and albuminuria, respectively. These trajectories included clinical events (ESKD, CVD, heart failure, death), eGFR decline, and patient-reported outcome measures (kidney disease QOL [KDQOL] burden, effects, and symptoms questionnaires, as well as the short-form-12 mental and physical composite).We also evaluated a group-based multi-trajectory model to group participants on the basis of longitudinal patient-reported outcome measures and compared group assignments by enrollment G- and A-stage. Results Mean participant age was 58 years, 45% were women, mean baseline eGFR was 44 mL/min/1.73 m2, and median urine albumin-to-creatinine ratio was 52 mg/g. The incidence of all clinical events was greater and eGFR decline was faster with more advanced G- and A-stages. While baseline KDQOL and physical component measures were lower with more advanced G- and A-stage of CKD; changes in patient-reported outcome measures were inconsistently related to the baseline CKD stage. Groups formed on patient-reported outcome measure trajectories were fairly distinct from existing CKD staging (observed agreement, 60.6%) but also were associated with risk of ESKD, CVD, heart failure, and death. Conclusions More advanced baseline CKD stage was associated with higher risk of clinical events and faster eGFR decline, but was only weakly related to changes in patient-reported metrics over time.

scholarly journals Piloting a web-based systematic collection and reporting of patient-reported outcome measures and patient-reported experience measures in chronic heart failure

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037754
Author(s):  
Francesca Pennucci ◽  
Sabina De Rosis ◽  
Claudio Passino
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Outcome Measures ◽  
Health Workers ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Population Characteristics ◽  
Web Based ◽  
Patient Reported ◽  
Systematic Collection

ObjectivesTo evaluate the feasibility of a digital and continuous collection and reporting of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) for chronic heart failure (CHF).DesignA single-site pilot study was settled for evaluating the feasibility of the intervention, both using qualitative and quantitative data (ie, workshop, surveys).SettingThe pilot has been implemented in a Tuscan specialised hospital (Italy).Participants162 patients were involved. Inclusion criteria were: a previous diagnosis of HF, age ≥18 years, absence of cognitive impairment or active tumours, ability to provide informed consent to study participation.InterventionThe continuous collection and reporting of PROMs and PREMs has been designed and implemented in 2018. PREMs questionnaires for patients were developed, while Kansas City Cardiomyopathy Questionnaire-12 was used for assessing PROMs. Questionnaires are administered at specific time points: discharge; 30 days, 7 and 12 months after the discharge. Enrolment of patients, administration and real-time reporting of questionnaires are carried on through a digital platform.Outcome measuresEnrolment, response and drop-out rates were considered to assess the feasibility of the intervention. Qualitative data were collected during meetings and workshops with health workers. The representativeness of the recruited sample with respect to the population characteristics was also evaluated.ResultsThe system has been successfully implemented during 2018. Response rates have been consistently above 50%, demonstrating patients’ transversal willingness to participate. All the involved stakeholders acknowledged the feasibility of the design. The recruited sample is significantly different in terms of age and educational level compared with the overall population characteristics.ConclusionIt is possible to run a web-based systematic collection and reporting system for CHF patient-reported data. Systematic collection and reporting of PROMs and PREMs data allows professionals to increasingly assume CHF patient perspective in their daily work. Limitations will be used to improve the system.

scholarly journals Correction to: Development of a conceptual model and patient-reported outcome measures for assessing symptoms and functioning in patients with heart failure

2020 ◽  
Vol 29 (10) ◽  
pp. 2849-2849
Author(s):  
Olga Moshkovich ◽  
Katy Benjamin ◽  
Katie Hall ◽  
Ryan Murphy ◽  
Robyn von Maltzahn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Conceptual Model ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
Patients With Heart Failure

The article Development of a conceptual model and patient-reported outcome measures for assessing symptoms and functioning in patients with heart failure.

scholarly journals Patient‐reported outcome measures and their utility in the management of patients with advanced chronic kidney disease

Nephrology ◽  
2019 ◽  
Vol 24 (8) ◽  
pp. 814-818 ◽  
Author(s):  
Kathryn Ducharlet ◽  
Vijaya Sundararajan ◽  
Jennifer Philip ◽  
Jennifer Weil ◽  
Nuala Barker ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Advanced Chronic Kidney Disease ◽  
Patient Reported

scholarly journals Integrating remote monitoring into heart failure patients’ care regimen: A pilot study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242210
Author(s):  
Albert Sohn ◽  
William Speier ◽  
Esther Lan ◽  
Kymberly Aoki ◽  
Gregg C. Fonarow ◽  
...  
Keyword(s):  
Heart Failure ◽  
Outcome Measures ◽  
Remote Monitoring ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Heart Failure Patients ◽  
Activity Tracker ◽  
Pill Bottle ◽  
Patient Reported ◽  
Two Factors

Background Around 50% of hospital readmissions due to heart failure are preventable, with lack of adherence to prescribed self-care as a driving factor. Remote tracking and reminders issued by mobile health devices could help to promote self-care, which could potentially reduce these readmissions. Objective We sought to investigate two factors: (1) feasibility of enrolling heart failure patients in a remote monitoring regimen that uses wireless sensors and patient-reported outcome measures; and (2) their adherence to using the study devices and completing patient-reported outcome measures. Methods Twenty heart failure patients participated in piloting a remote monitoring regimen. Data collection included: (1) physical activity using wrist-worn activity trackers; (2) body weight using bathroom scales; (3) medication adherence using smart pill bottles; and (4) patient -reported outcomes using patient-reported outcome measures. Results We evaluated 150 hospitalized heart failure patients and enrolled 20 individuals. Two factors contributed to 50% (65/130) being excluded from the study: smartphone ownership and patient discharge. Over the course of the study, 60.0% of the subjects wore the activity tracker for at least 70% of the hours, and 45.0% used the scale for more than 70% of the days. The pill bottle was used less than 10% of the days by 55.0% of the subjects. Conclusions Our method of recruiting heart failure patients prior to hospital discharge may not be feasible as the enrollment rate was low. Once enrolled, the majority of subjects maintained a high adherence to wearing the activity tracker but low adherence to using the pill bottle and completing the follow-up surveys. Scale usage was fair, but it received positive reviews from most subjects. Given the observed usage and feedback, we suggest mobile health-driven interventions consider including an activity tracker and bathroom scale. We also recommend administering a shorter survey more regularly and through an easier interface.

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