Patient-reported outcomes in RA care improve patient communication, decision-making, satisfaction and confidence: qualitative results
To evaluate the impact of integrating patient-reported outcomes (PROs) into routine clinics, from the perspective of patients with RA, clinicians and other staff. We conducted a prospective cohort study using a mixed methods sequential explanatory design at an academic arthritis clinic. RA patients...
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| Vydáno v: | Rheumatology (Oxford, England) Ročník 59; číslo 7; s. 1662 |
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| Hlavní autoři: | , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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England
01.07.2020
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| ISSN: | 1462-0332, 1462-0332 |
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| Abstract | To evaluate the impact of integrating patient-reported outcomes (PROs) into routine clinics, from the perspective of patients with RA, clinicians and other staff.
We conducted a prospective cohort study using a mixed methods sequential explanatory design at an academic arthritis clinic. RA patients completed selected Patient-Reported Outcomes Measurement Information System measures on tablets in the waiting room. Results were immediately available to discuss during the visit. Post-visit surveys with patients and physicians evaluated topics discussed and their impact on decision making; patients rated confidence in treatment. Focus groups or interviews with patients, treating rheumatologists and clinic staff were conducted to understand perspectives and experiences.
Some 196 patients and 20 rheumatologists completed post-visit surveys at 816 and 806 visits, respectively. Focus groups were conducted with 24 patients, 10 rheumatologists and 4 research/clinic staff. PROs influenced medical decision-making and RA treatment changes (38 and 18% of visits, respectively). Patients reported very high satisfaction and treatment confidence. Impact on clinical workflow was minimal after a period of initial adjustment. PROs were valued by patients and physicians, and provided new insight into how patients felt and functioned over time. Reviewing results together improved communication, and facilitated patient-centred care, shared decision making, and the identification of new symptoms and contributing psychosocial/behavioural factors.
PRO use at RA visits was feasible, increased understanding of how disease affects how patients feel and function, facilitated shared decision-making, and was associated with high patient satisfaction and treatment confidence. |
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| AbstractList | To evaluate the impact of integrating patient-reported outcomes (PROs) into routine clinics, from the perspective of patients with RA, clinicians and other staff.
We conducted a prospective cohort study using a mixed methods sequential explanatory design at an academic arthritis clinic. RA patients completed selected Patient-Reported Outcomes Measurement Information System measures on tablets in the waiting room. Results were immediately available to discuss during the visit. Post-visit surveys with patients and physicians evaluated topics discussed and their impact on decision making; patients rated confidence in treatment. Focus groups or interviews with patients, treating rheumatologists and clinic staff were conducted to understand perspectives and experiences.
Some 196 patients and 20 rheumatologists completed post-visit surveys at 816 and 806 visits, respectively. Focus groups were conducted with 24 patients, 10 rheumatologists and 4 research/clinic staff. PROs influenced medical decision-making and RA treatment changes (38 and 18% of visits, respectively). Patients reported very high satisfaction and treatment confidence. Impact on clinical workflow was minimal after a period of initial adjustment. PROs were valued by patients and physicians, and provided new insight into how patients felt and functioned over time. Reviewing results together improved communication, and facilitated patient-centred care, shared decision making, and the identification of new symptoms and contributing psychosocial/behavioural factors.
PRO use at RA visits was feasible, increased understanding of how disease affects how patients feel and function, facilitated shared decision-making, and was associated with high patient satisfaction and treatment confidence. To evaluate the impact of integrating patient-reported outcomes (PROs) into routine clinics, from the perspective of patients with RA, clinicians and other staff.OBJECTIVETo evaluate the impact of integrating patient-reported outcomes (PROs) into routine clinics, from the perspective of patients with RA, clinicians and other staff.We conducted a prospective cohort study using a mixed methods sequential explanatory design at an academic arthritis clinic. RA patients completed selected Patient-Reported Outcomes Measurement Information System measures on tablets in the waiting room. Results were immediately available to discuss during the visit. Post-visit surveys with patients and physicians evaluated topics discussed and their impact on decision making; patients rated confidence in treatment. Focus groups or interviews with patients, treating rheumatologists and clinic staff were conducted to understand perspectives and experiences.METHODSWe conducted a prospective cohort study using a mixed methods sequential explanatory design at an academic arthritis clinic. RA patients completed selected Patient-Reported Outcomes Measurement Information System measures on tablets in the waiting room. Results were immediately available to discuss during the visit. Post-visit surveys with patients and physicians evaluated topics discussed and their impact on decision making; patients rated confidence in treatment. Focus groups or interviews with patients, treating rheumatologists and clinic staff were conducted to understand perspectives and experiences.Some 196 patients and 20 rheumatologists completed post-visit surveys at 816 and 806 visits, respectively. Focus groups were conducted with 24 patients, 10 rheumatologists and 4 research/clinic staff. PROs influenced medical decision-making and RA treatment changes (38 and 18% of visits, respectively). Patients reported very high satisfaction and treatment confidence. Impact on clinical workflow was minimal after a period of initial adjustment. PROs were valued by patients and physicians, and provided new insight into how patients felt and functioned over time. Reviewing results together improved communication, and facilitated patient-centred care, shared decision making, and the identification of new symptoms and contributing psychosocial/behavioural factors.RESULTSSome 196 patients and 20 rheumatologists completed post-visit surveys at 816 and 806 visits, respectively. Focus groups were conducted with 24 patients, 10 rheumatologists and 4 research/clinic staff. PROs influenced medical decision-making and RA treatment changes (38 and 18% of visits, respectively). Patients reported very high satisfaction and treatment confidence. Impact on clinical workflow was minimal after a period of initial adjustment. PROs were valued by patients and physicians, and provided new insight into how patients felt and functioned over time. Reviewing results together improved communication, and facilitated patient-centred care, shared decision making, and the identification of new symptoms and contributing psychosocial/behavioural factors.PRO use at RA visits was feasible, increased understanding of how disease affects how patients feel and function, facilitated shared decision-making, and was associated with high patient satisfaction and treatment confidence.CONCLUSIONPRO use at RA visits was feasible, increased understanding of how disease affects how patients feel and function, facilitated shared decision-making, and was associated with high patient satisfaction and treatment confidence. |
| Author | Haque, Uzma J Jones, Michelle R De Leon, Elaine Bingham, Clifton O Ruffing, Victoria Perin, Jamie Orbai, Ana-Maria Manno, Rebecca L Butanis, Alessandra Bartlett, Susan J Smith, Katherine Clegg Leong, Amye Duncan, Trisha |
| Author_xml | – sequence: 1 givenname: Susan J surname: Bartlett fullname: Bartlett, Susan J organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University – sequence: 2 givenname: Elaine surname: De Leon fullname: De Leon, Elaine organization: Center for Qualitative Studies in Health and Medicine, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD – sequence: 3 givenname: Ana-Maria surname: Orbai fullname: Orbai, Ana-Maria organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University – sequence: 4 givenname: Uzma J surname: Haque fullname: Haque, Uzma J organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University – sequence: 5 givenname: Rebecca L surname: Manno fullname: Manno, Rebecca L organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University – sequence: 6 givenname: Victoria surname: Ruffing fullname: Ruffing, Victoria organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University – sequence: 7 givenname: Alessandra surname: Butanis fullname: Butanis, Alessandra organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University – sequence: 8 givenname: Trisha surname: Duncan fullname: Duncan, Trisha organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University – sequence: 9 givenname: Michelle R surname: Jones fullname: Jones, Michelle R organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University – sequence: 10 givenname: Amye surname: Leong fullname: Leong, Amye organization: Healthy Motivation, Santa Barbara, CA – sequence: 11 givenname: Jamie surname: Perin fullname: Perin, Jamie organization: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA – sequence: 12 givenname: Katherine Clegg surname: Smith fullname: Smith, Katherine Clegg organization: Center for Qualitative Studies in Health and Medicine, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD – sequence: 13 givenname: Clifton O surname: Bingham fullname: Bingham, Clifton O organization: Division of Rheumatology, Department of Medicine, Johns Hopkins University |
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| Keywords | patient-reported outcomes clinical practice qualitative research rheumatoid arthritis PROMIS |
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| Title | Patient-reported outcomes in RA care improve patient communication, decision-making, satisfaction and confidence: qualitative results |
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