Session Title: Patient Outcomes, Preferences, and Attitudes Poster III
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Although optimal care is patient-centered and grounded in shared decision-making (SDM) between patients and providers, rheumatologists often have little insight into the day-to-day experiences of their patients with inflammatory arthritis. We hypothesized that the use of validated patient-reported outcomes (PROs) querying RA symptoms and impact would provide insight into patient priorities, values, and preferences and facilitate SDM around treatment choices.
Methods: Participants in an observational study at an academic arthritis center completed PROMIS fatigue, pain, physical function, sleep, and participation on a tablet in the waiting room. Reports of results in numerical and graphical formats were available during the visit for review and discussion with the rheumatologist. Within 48 hours of the clinic visit, patients completed surveys about the relevancy and impact on the clinical visit. In-depth interviews were conducted with a subset.
Results: Survey data are from 68 patients who were mostly white (85%), female (81% with a mean age of 54 (13) and RA duration of 10 (9) years. Interviews with 15 participants provided additional support to themes identified in the survey. Almost all (94%) reported the PRO question addressed important aspects of their health:
- Addresses a wide range of issues, which is great
- It shows the impact my arthritis has on me, not just the pain
- Helps give a better overall picture of what’s going on
Most (82%) reported the discussion of results during the visit improved communication and made it easier to raise issues:
- I love seeing data and graphs — it really helps me
- It focuses…discussion with your physician so you can address the most pressing, sort of prioritize, the issues you want to address
- Doctor referred to my answers during discussion
A few (3%) were unclear if PRO results had been reviewed, or whether care was impacted:
- I think my doctor [already] treats me well
Conclusion: Patients place high value on PRO information which gives insight into day-to-day life and unmet needs. Expanded PRO assessment with real time review of results provides an opportunity for more patient-centered RA care and SDM by guiding conversations and improving communication about disease-related symptoms and impacts that matter to patients.
Funding PCORI IP2-PI0000737, SC14-1402-10818.
To cite this abstract in AMA style:Bingham CO III, Clegg Smith K, de Leon E, Jones M, Gutierrez AK, Butanis A, Bartlett SJ. Using PROs to Guide Patient-Centered Conversations and Care in Inflammatory Arthritis: The Patient Perspective [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). http://acrabstracts.org/abstract/using-pros-to-guide-patient-centered-conversations-and-care-in-inflammatory-arthritis-the-patient-perspective/. Accessed May 20, 2018.
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