Integrating patient-reported outcomes into rheumatology practice – UROP Spring Symposium 2021

Integrating patient-reported outcomes into rheumatology practice

Faith Reger


Pronouns: she/her

Research Mentor(s): Yomei Shaw, Postdoctoral Fellow
Research Mentor School/College/Department: Division of Rheumatology, Michigan Medicine
Presentation Date: Thursday, April 22, 2021
Session: Session 5 (3pm-3:50pm)
Breakout Room: Room 13
Presenter: 3

Event Link


Background: Many patients with rheumatic diseases have symptoms like pain and fatigue in spite of their treatment [1,2]. Patients also often disagree with their health care providers (HCPs) in their perceptions about their disease [3]. One method that helps facilitate better patient-provider communication about symptoms is the use of patient reported outcomes (PROs). PROs are a patient’s self report of their health status or symptoms. Many HCPs in the Division of Rheumatology do not use PROs in their clinical practice. Objectives: The aim of this study is to assess the impacts, barriers, and facilitators of incorporating PROMIS measures for pain, physical function, and sleep disturbance into clinical rheumatology practice. Methods: This is a mixed methods study which will evaluate strategies to promote use of PROMIS using quantitative data from a controlled trial and qualitative data from interviews and observations. There are three arms for this trial: (1) patients receive PRO scores, (2) patients receive PRO scores, but HCPs do not, and (3) patients and HCPs receive PRO scores. Qualitative interviews with patients and HCPs, observations of appointments, HCP feedback, and surveys will be used to identify the barriers and facilitators to integrating PROs in clinical practice. Results: We are currently preparing for the main trial, which is planned to run from September 2021 through February 2022. We are currently conducting interviews with HCPs and patient stakeholders to evaluate the feasibility and acceptability of the study materials and help us understand barriers to the use of PROs in clinical practice. We found that some HCPs think PROs could be a good resource for physicians, but other HCPs believe that PROs will not be beneficial because patients may not use provided self-help resources. We anticipate that PROs will improve patient-provider communication, but it may be difficult to observe any benefits regarding health outcomes. Conclusion: Going forward, we hope that with the integration of PROs into UM’s Division of Rheumatology, we will see a subsequent rise in PRO use in practice as HCPs realize the benefits. To encourage PRO use by HCPs, it is essential to address any concerns they may have regarding clinic workflow, as well as show them how PROs will help their patients with managing their symptoms. 1. Ishida M, Kuroiwa Y, Yoshida E, Sato M, Krupa D, Henry N, et al. Residual symptoms and disease burden among patients with rheumatoid arthritis in remission or low disease activity: a systematic literature review. Modern Rheumatology 2018;28:789-799. 2. Fautrel B, Alten R, Kirkham B, Torre I de la, Durand F, Barry J, et al. Call for action: how to improve use of patient-reported outcomes to guide clinical decision making in rheumatoid arthritis. Rheumatol Int 2018;38:935-947. 3. Gvozdenovic E, Koevoets R, Wolterbeek R, Heijde D van der, Huizinga TWJ, Allaart CF, et al. Assessment of global disease activity in RA patients monitored in the METEOR database: the patient’s versus the rheumatologist’s opinion. Clin Rheumatol 2014;33:461-466.

Authors: Faith Reger, Neda Kortam, Yomei Shaw, Adam Chalak, Yujia Li, Dinesh Khanna
Research Method: Clinical Research

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