Background/Purpose:   Improving patient experience is important in all diseases, but most important in patients with chronic rheumatic diseases like rheumatoid arthritis. To date there have been no specific patient reported experience measures (PREMs) in rheumatology.  A multi-disciplinary group ¸commisioning for quality in rheumatoid arthritis (CQRA) was established to develop the first PREM in RA, this  group was supported under the terms of a joint working agreement with Roche Products Ltd. Firstly, a series of focus groups was held with patients from the UK National Rheumatoid Arthritis  Society to determine which elements of the patient experience was deemed most important and this was mapped against  UK Department of Health Patient Experience Framework. This framework comprises 8 domains. A questionnaire was developed using the same 8 domains, but with questions developed specifically relating to RA and Rheumatology Services and these were piloted across ten UK sites. The final question asked  respondents to evaluate their overall level of care. All questions were graded from very satisfied to very unsatisfied on a five point scale.

Aim: To determine the construct validity of the PREM questionnaire developed by the CQRA group.

Methods: Cronbachs alpha was used to check internal consistency within groups of scores in each domain if it contained more than one question  and whether it was reasonable to combine scores within groups into a numerical scale.  Additionally for each question the percentage agreement with the overall assessment on the five point scale was calculated, in case of multiple questions per domain, the responses are shown as a range.

Results:

524 patients were included in the analysis, median age was 65 years (IQR 55,80 years).  377 (72%) were female. Median disease duration was 8 years (IQR 3.5, 15 years).  The Cronbach alpha co-efficients within the multi-question domains and their percentage agreement with the question on overall care are shown in table1 below.

Domain	Number of questions	Alpha within domain	%Agreement with overall care
Needs and preferences	5	0.90	64.5-67.2
Co-ordination of care	4	0.87	59.1-69.1
Information about care	4	0.75	22.5-66.4
Daily living	2	0.61	33.2-53.4
Emotional support	2	0.84	53.5-68.9
Family and friends	1	–	61.8
Access to care	1	–	70.4

Table 1. Result of Cronbach’s alpha analysis and their agreement with overall care

Conclusion: The PREM has good construct validity and is a valid tool for measuring RA patient experience. Some domains have higher agreement with overall patient experience. This could provide a useful future tool for measuring patient experience. Modification of the tool to use in other rheumatic conditions is underway.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/validation-of-a-patient-reported-experience-measure-in-patients-with-rheumatoid-arthritis/