Integration of Patient-reported Outcomes Assessment Into Routine Care for Patients Receiving Residential Treatment for Alcohol and/or Substance Use Disorder

Abstract Aims Incorporating patient-reported outcomes (PROs) into routine care of atrial fibrillation (AF) enables direct integration of symptoms, function, and health-related quality of life (HRQoL) into practice. We report our initial experience with a system-wide PRO initiative among AF patients. Methods and results All patients with AF in our practice undergo PRO assessment with the Toronto AF Severity Scale (AFSS), and generic PROs, prior to electrophysiology clinic visits. We describe the implementation, feasibility, and results of clinic-based, electronic AF PRO collection, and compare AF-specific and generic HRQoL assessments. From October 2016 to February 2019, 1586 unique AF patients initiated 2379 PRO assessments, 2145 of which had all PRO measures completed (90%). The median completion time for all PRO measures per visit was 7.3 min (1st, 3rd quartiles: 6, 10). Overall, 38% of patients were female (n = 589), mean age was 68 (SD 12) years, and mean CHA2DS2-VASc score was 3.8 (SD 2.0). The mean AFSS symptom score was 8.6 (SD 6.6, 1st, 3rd quartiles: 3, 13), and the full range of values was observed (0, 35). Generic PROs of physical function, general health, and depression were impacted at the most severe quartiles of AF symptom score (P < 0.0001 for each vs. AFSS quartile). Conclusion Routine clinic-based, PRO collection for AF is feasible in clinical practice and patient time investment was acceptable. Disease-specific AF PROs add value to generic HRQoL instruments. Further research into the relationship between PROs, heart rhythm, and AF burden, as well as PRO-guided management, is necessary to optimize PRO utilization.

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Item banks for substance use from the Patient-Reported Outcomes Measurement Information System (PROMIS ® ): Severity of use and positive appeal of use

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2015.09.008 ◽

2015 ◽

Vol 156 ◽

pp. 184-192 ◽

Cited By ~ 12

Author(s):

Paul A. Pilkonis ◽

Lan Yu ◽

Nathan E. Dodds ◽

Kelly L. Johnston ◽

Suzanne M. Lawrence ◽

...

Keyword(s):

Information System ◽

Substance Use ◽

Patient Reported Outcomes ◽

Measurement Information ◽

Outcomes Measurement ◽

Item Banks ◽

Patient Reported ◽

Measurement Information System

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What Really Matters Is Rarely Measured: Outcome of Routine Care and Patient-reported Outcomes

European Urology ◽

10.1016/j.eururo.2013.01.030 ◽

2013 ◽

Vol 64 (1) ◽

pp. 58-59 ◽

Cited By ~ 2

Author(s):

Manfred P. Wirth ◽

Johannes Huber

Keyword(s):

Patient Reported Outcomes ◽

Routine Care ◽

Patient Reported

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CANKADO PRO-React: E-health solution with dynamic symptom questionnaires and automated recommendations for cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.7_suppl.7 ◽

2018 ◽

Vol 36 (7_suppl) ◽

pp. 7-7

Author(s):

Timo Schinkothe ◽

Susan Praveen ◽

Abhishek Lal ◽

Baiju Rahman

Keyword(s):

Cancer Patients ◽

Patient Reported Outcomes ◽

Automated Analysis ◽

Routine Care ◽

Patient Relationship ◽

Conventional Chemotherapy ◽

Online Documentation ◽

Patient Reported ◽

Automated Feedback ◽

Dynamic Recognition

7 Background: It is proven that the online documentation and transmission of symptoms can prolong the overall survival of cancer patients. Recent studies have shown that this advantage exists both in conventional chemotherapy and in oral therapy.Current implementations require a healthcare professional who monitors the data online. In most centers, such kind of human resources is not available except in clinical trials. It was therefore the goal of this project to develop an eHealth procedure, in which no permanent online observation is necessary. Methods: PRO-React, a symptom-based automated feedback or advice feature is integrated into the eHealth platform CANKADO. In the online settings, physician activates medication plans for his patients, documents drug-taking and sets reminders for the patient of future intake times. PRO-React assists the patients daily in global health documentation and dynamic symptom questionnaires. A built-in automated analysis brings forth suitable recommendations for patients like discuss with the physician, visit the physician immediately, visit directly or go to ER. The patient reported outcomes are shared in real-time with the physicians. Results: Trials are ongoing. Interim analysis is planed for January 2018. Results will be presented at the conference. Conclusions: PRO-React helps in the dynamic recognition of events with minimal daily documentation from the patients as well as assist in reacting to the needs of the patients. It also circumvents the need of a mediator group like nurses and thereby increase compliance and improve the doctor-patient-relationship leading to decreased mortality and higher patient satisfaction. PRO-React is available for routine care but also included into several multi-center trials.

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Nurse, oncologist, and patient impressions of electronic symptom monitoring via patient-reported outcomes in community oncology practices: Qualitative results from the U.S. national PRO-TECT trial (AFT-39, NCT03249090).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.7044 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 7044-7044

Author(s):

Ethan M. Basch ◽

Randall Teal ◽

Amylou C. Dueck ◽

Jennifer Jansen ◽

Sydney Henson ◽

...

Keyword(s):

Quality Of Care ◽

Patient Reported Outcomes ◽

Positive Impact ◽

Care Delivery ◽

Routine Care ◽

Office Visits ◽

Symptom Monitoring ◽

Community Oncology ◽

Patient Reported

7044 Background: There is growing interest to implement electronic patient-reported outcomes in oncology practices for symptom monitoring. It is not well known what nurse, physician, and patient impressions of benefits, acceptability, and challenges are in routine care use. Methods: PRO-TECT is an ongoing U.S. national trial including 26 community oncology practices across 15 states that implemented PRO symptom monitoring [NCT03249090]. Patients complete weekly PROs between visits, nurses receive alerts for severe/worsening symptoms, and oncologists review PROs at office visits. Interviews were conducted with 147 stakeholders including nurses (N = 46), oncologists (N = 27), data managers (N = 15), and patients (N = 59). Each stakeholder group had different interview guides with overlapping topics to explore experiences with the PRO system. Interviews lasted 15-60 minutes, were digitally recorded, transcribed, and entered into a qualitative analysis software program. A codebook was developed from the research questions, interview guides, and discussions with the project team. Standardized coding methods were applied, with transcripts double coded for thematic analysis. Feedback surveys were also completed by nurses (N = 57), oncologists (N = 38), and patients (N = 435). Results: Key benefits perceived across stakeholder groups included increased patient self-awareness of symptoms; improved direct communication of patients with care teams; more open and honest conveying of symptom experiences; ability to track symptoms over time; and increased involvement of patients in their own care. Most stakeholders felt PRO symptom monitoring had a positive impact on quality of care delivery, and believed benefits of PROs outweighed necessary staff efforts. Challenges included additional work by nurses to review and respond to alerts, staff turnover requiring retraining, and limited time of oncologists. In the survey, 39/56 (70%) nurses felt the PRO system improved quality of care; 27/33 (82%) oncologists noted PROs were useful for team discussions and care delivery; and 320/434 (74%) patients agreed that weekly PRO reporting improved discussions with their care team. Conclusions: Clinicians and patients perceived weekly PRO symptom monitoring between visits to be valuable despite added staff effort. Results of additional analyses are forthcoming. Clinical trial information: NCT03249090 .

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