556 Patient-centered care: Clinical relevance of PROMIS domains in atopic dermatitis, acne, and psoriasis

Abstract

PROMIS (patient-reported outcome measures information system) is designed to track specific health domains across all diseases and disciplines. This study identified the relevance of three PROMIS domain outcomes in atopic dermatitis, acne, and psoriasis. A PROMIS health assessment, containing computer adaptive tests (CAT) for four domains (Anxiety, Mood, Pain Interference, and Physical Function), was administered on iPads during routine care in three Dermatology clinics at University of Rochester. Pain Interference, Mood, and Anxiety scores >55 were considered notable. All statistical analyses (ANOVA, chi square, fisher exact tests) were performed at significance level of 0.05 using JMP Pro12. Of 27,339 office visits, PROMIS data were captured for 4,523 visits. Domain order significantly influenced completion of the PROMIS health assessment. Completion rates were higher when Anxiety was first domain instead of Physical Function (73.4% vs. 63.5%, p<0.001). Age and gendermatched chart reviews of patients with notable and not notable domain scores revealed significant associations with certain diagnoses. Atopic dermatitis impacted physical health (i.e., Pain Interference), whereas acne and psoriasis impacted social health (i.e., Anxiety or Mood). Atopic dermatitis patients with notable Pain Interference had severe disease, higher percentage body surface area of disease, uncontrolled disease, and/or unsuccessful treatment (p<0.04). Acne patients with notable Anxiety had severe disease, scarring, and/or presence of mental health comorbidity (p<0.04). Psoriasis patients with notable Mood had severe disease, uncontrolled disease, unsuccessful treatment, and/or presence of mental health comorbidity (p<0.01). PROMIS domains capture clinically significant changes in patients physical and mental health associated with their dermatologic disease and treatment. The quality of patient-centered care in Dermatology may be improved with PROMIS utilization.