Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic

Moura, Lidia M.V.R.; Schwamm, Eli; Moura, Valdery; Seitz, Michael P.; Hsu, John; Cole, Andrew J.; Schwamm, Lee H

doi:10.1212/wnl.0000000000003409

Cited by 25 publications

(21 citation statements)

References 32 publications

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“…Lastly, one out of four patients received help to answer the questions. This may have increased the T-scores since proxy's tend to report worse patient-reported outcomes compared to the patient (20,22).…”

Section: Discussionmentioning

confidence: 99%

Patient Reported Outcomes Measurements Information System in Stroke Patients in Full and Shortened Format

et al. 2021

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Introduction: The modified Rankin Scale (mRS) after 90 days documents outcome in stroke patients, but focusses only on activities of daily living. Here we studied stroke outcome beyond these activities by the Dutch-Flemish version of the Patient Reported Outcomes Measurement Information System (PROMIS) questionnaire.Patients and Methods: We documented the mRS at day 90 in stroke patients who filled out a questionnaire on pain intensity and seven PROMIS domains: physical function, ability to participate in social roles, anxiety, fatigue, depression, sleep disturbance, pain interference. In a subgroup of patients this questionnaire was reduced to one overall question per PROMIS domain. We correlated these findings with the mRS.Results: We received 102 questionnaires and identified physical function as the most affected PROMIS domain. The strongest correlation with mRS was found for the health domains of physical function (ρs = 0.70, p < 0.001) and ability to participate in social roles (ρs = 0.61, p < 0.001). The other domains with substantial proportions of patients with worse scores compared to the general population (19–44%) correlated weakly with the mRS. We identified a strong correlation between the single question per health domain and the overall score per PROMIS domain.Discussion and Conclusion: PROMIS better reflects the overall health status of stroke patients beyond functional outcome as measured by the mRS. Simplification of the questionnaire with a single question per PROMIS domain could potentially replace the full questionnaire, but needs further validation.

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Section: Discussionmentioning

confidence: 99%

Patient Reported Outcomes Measurements Information System in Stroke Patients in Full and Shortened Format

et al. 2021

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“…Some authors have shown that increasing age is associated with decreased preference for tablet questionnaires over paper version [ 27 ], increased time needed to complete tablet questionnaires [ 38 ], and increased difficulty using tablets [ 6 , 11 , 22 , 28 , 29 ]. However, others have reported no significant influence of increasing age on tablet questionnaire usability, feasibility, and preference over paper versions [ 4 , 5 , 25 , 39 ]. Interestingly, being older than 65 years of age was not associated with failure to complete the tablet questionnaire in patients who accepted it.…”

Section: Discussionmentioning

confidence: 99%

Primary Care Pre-Visit Electronic Patient Questionnaire for Asthma: Uptake Analysis and Predictor Modeling

Kouri¹,

Yamada²,

Sale³

et al. 2020

J Med Internet Res

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Background mHealth tablet-based interventions are increasingly being studied and deployed in various health care settings, yet little knowledge exists regarding patient uptake and acceptance or how patient demographics influence these important implementation metrics. Objective To determine which factors influence the uptake and successful completion of an mHealth tablet questionnaire by analyzing its implementation in a primary care setting. Methods We prospectively studied a patient-facing electronic touch-tablet asthma questionnaire deployed as part of the Electronic Asthma Management System. We describe tablet uptake and completion rates and corresponding predictor models for these behaviors. Results The tablet was offered to and accepted by patients in 891/1715 (52.0%) visits. Patients refused the tablet in 33.0% (439/1330) visits in which it was successfully offered. Patients aged older than 65 years of age (odds ratio [OR] 2.30, 95% CI 1.33-3.95) and with concurrent chronic obstructive pulmonary disease (OR 2.22, 95% CI 1.05-4.67) were more likely to refuse the tablet, and those on an asthma medication (OR 0.55, 95% CI 0.30-0.99) were less likely to refuse it. Once accepted, the questionnaire was completed in 784/891 (88.0%) instances, with those on an asthma medication (OR 0.53, 95% CI 0.32-0.88) being less likely to leave it incomplete. Conclusions Older age predicted initial tablet refusal but not tablet questionnaire completion, suggesting that perceptions of mHealth among older adults may negatively impact uptake, independent of usability. The influence of being on an asthma medication suggests that disease severity may also mediate mHealth acceptance. Although use of mHealth questionnaires is growing rapidly across health care settings and diseases, few studies describe their real-world acceptance and its predictors. Our results should be complemented by qualitative methods to identify barriers and enablers to uptake and may inform technological and implementation strategies to drive successful usage.

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“…e-PRO is a term used by some to indicate electronic-entered PROs, which provide information comparable to that provided by questionnaires completed on paper [108,109,110], and have the added benefit of not requiring separate data entry. Sometimes the entry is at the time of the visit with the clinician, either via a kiosk [111] or a tablet [112]. When this is completed before seeing the clinician, the information can be available just before or during the visit.…”

Section: Characteristics Of the New Systemmentioning

confidence: 99%

Characteristics of Future Models of Integrated Outpatient Care

et al. 2019

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Replacement of fee-for-service with capitation arrangements, forces physicians and institutions to minimize health care costs, while maintaining high-quality care. In this report we described how patients and their families (or caregivers) can work with members of the medical care team to achieve these twin goals of maintaining—and perhaps improving—high-quality care and minimizing costs. We described how increased self-management enables patients and their families/caregivers to provide electronic patient-reported outcomes (i.e., symptoms, events) (ePROs), as frequently as the patient or the medical care team consider appropriate. These capabilities also allow ongoing assessments of physiological measurements/phenomena (mHealth). Remote surveillance of these communications allows longer intervals between (fewer) patient visits to the medical-care team, when this is appropriate, or earlier interventions, when it is appropriate. Systems are now available that alert medical care providers to situations when interventions might be needed.

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Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic

Cited by 25 publications

References 32 publications

Patient Reported Outcomes Measurements Information System in Stroke Patients in Full and Shortened Format

Patient Reported Outcomes Measurements Information System in Stroke Patients in Full and Shortened Format

Primary Care Pre-Visit Electronic Patient Questionnaire for Asthma: Uptake Analysis and Predictor Modeling

Characteristics of Future Models of Integrated Outpatient Care

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