Background/Purpose: Patient reported outcomes are important to measure the effectiveness of non-pharmacological and pharmacological interventions. The goal of PROMIS is to develop standardized items banks for use across different conditions [1]. The PROMIS-29, which assesses difficulty with activities and symptom severity, has been shown to be valid for patients with SSc [2]. However, other PROMIS measures, such as the PROMIS Self-Efficacy scales may be important to the management of a chronic disease such as SSc.

Methods: Participants with SSc, who were part of a larger study on self-management, completed the PROMIS Self-Efficacy Scales and PROMIS-29. PROMIS-29 includes physical function, anxiety, depression, fatigue, sleep disturbance, pain interference, and satisfaction with social roles, while the PROMIS self-efficacy scales measure self-efficacy for emotions, symptoms, daily activities, social interactions, and medication and treatment. Patients also completed a demographic questionnaire and the Patient Health Questionnaire (PHQ). Significant differences in PROMIS and PROMIS-29 scales between subgroups were determined using t-tests, Wilcoxon tests or Fisher’s exact tests depending on the distribution of the variables. t-tests were used for variables that were approximately normally distributed, non-parametric Wilcoxon tests for non-normally distributed variables and Fisher’s exact tests for discrete, categorical variables.

Results:

267 participants completed the questionnaires. Mean age was 53.7 years, disease duration from onset of first SSc symptoms was 11.9 yrs. 91% were women and 82.8 % were white. There were significant differences in all PROMIS self-efficacy and all PROMIS-29 scale scores between patients without depressed mood (PHQ-8 <10) vs depressed mood (PHQ-8 >10). Married patients had significantly better PROMS Self-Efficacy for social interaction and PROMIS-29 scores for social role, anxiety, depression, and fatigue. Participants who were employed full time had significantly better scores on the PROMIS self-efficacy scales for managing symptoms, daily activities and medications and treatment compared to participants not employed full time. For the PROMIS-29, significant differences were found for scales relative to physical function, social role, depression, fatigue, pain interference and pain intensity.

Disease duration (< median value or > median value) significantly affected PROMIS self-efficacy scales only with respect to managing daily activities and physical function. No significance differences in PROMIS self-efficacy or PROMIS-29 scores were observed between patients with different subtypes of SSc (diffuse vs limited/sine), education level (< or > 12^th grade) or race (white versus non-white).

Conclusion:

Patients with SSc who did not have depressed mood, had education above the 12^th grade, were married and employed full time had higher PROMIS-29 and PROMIS Self-Efficacy scores.

References:

[1] Reeve BB et al. Med Care 2007;45:S22-31

[2] Hinchcliff M et al. Arthritis Care Res 2011;63:1620-1628

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/performance-of-patient-reported-outcomes-measurement-information-systems-promis-promis-29-and-promis-self-efficacy-in-systemic-sclerosis-ssc/