一项评估银屑病关节炎或强直性脊柱炎患者自我报告结局指标的新型定性研究。

A Novel Qualitative Study Assessing Patient-Reported Outcome Measures Among People Living with Psoriatic Arthritis or Ankylosing Spondylitis.

作者信息

Chakravarty Soumya D, Abell Jill, Leone-Perkins Megan, Orbai Ana-Maria

机构信息

Janssen Scientific Affairs, LLC, Horsham, PA, USA.

Drexel University College of Medicine, Philadelphia, PA, USA.

出版信息

Rheumatol Ther. 2021 Mar;8(1):609-620. doi: 10.1007/s40744-021-00289-w. Epub 2021 Feb 22.

Abstract

INTRODUCTION

Patient-reported outcome measures (PROMs) are used to capture patient perspectives in disease assessment. The objective of this study was to capture feedback about commonly used PROMs for spondyloarthritis (SpA) through semi-structured group discussions with individuals diagnosed with psoriatic arthritis (PsA) or ankylosing spondylitis (AS). The goal was to identify PROM content that most resonated with patient experiences and is therefore suitable for implementation in SpA clinical practice.

METHODS

Semi-structured tasks and probes were designed to elicit qualitative patient feedback on several general health and disease-specific PROMs. During a series of in-person and telephone meetings, participants with PsA or AS were asked to identify content that resonated with them and to identify items that may not have captured their personal experiences living with their disease. Both individualized and small group review and concept elicitation were captured after participant review of PROMs.

RESULTS

Both PsA and AS participants identified concepts that reflected their experiences living with a chronic disease, including fatigue, isolation, depression, inter-personal relationships, and sexual intimacy. Constructs incorporated into existing PROMs, such as pain, physical function, ability to perform activities of daily living, and stiffness, were also identified as important to participants. There were a few qualitative differences in participant perceptions about what they would like to see addressed by PROMs. For example, AS participants said that they would like to see PROMs elicit feedback about their experiences with pelvic and chest pain (e.g., as a result of chest inflammation/tenderness and chest expansion). PsA participants felt that PROMs should include measures about the embarrassment and shame that they experience as well as the impact of PsA on their daily lives.

CONCLUSION

Results of these qualitative assessments suggest that PROMs should be incorporated more frequently in outpatient settings to help improve the quality of decision-making conversations between patients and their healthcare providers. Participants indicated that constructs such as isolation, depression, fatigue, and relationships with others were critical to inform healthcare professionals about the patient experience of living with their disease.

摘要

引言

患者报告结局量表(PROMs)用于在疾病评估中获取患者的观点。本研究的目的是通过与诊断为银屑病关节炎(PsA)或强直性脊柱炎(AS)的个体进行半结构化小组讨论,收集有关脊柱关节炎(SpA)常用PROMs的反馈。目标是确定最能引起患者共鸣、因此适合在SpA临床实践中应用的PROM内容。

方法

设计了半结构化任务和探究问题,以获取患者对几种一般健康和疾病特异性PROMs的定性反馈。在一系列面对面和电话会议中,要求PsA或AS患者识别与他们产生共鸣的内容,并识别可能未涵盖其疾病生活个人经历的项目。在患者对PROMs进行审查后,记录了个性化和小组审查及概念引出情况。

结果

PsA和AS患者均识别出反映其慢性病生活经历的概念,包括疲劳、孤立、抑郁、人际关系和性亲密。现有PROMs中纳入的结构,如疼痛、身体功能、进行日常生活活动的能力和僵硬,也被确定对患者很重要。患者对PROMs希望解决的问题的看法存在一些定性差异。例如,AS患者表示,他们希望看到PROMs引出有关其骨盆和胸痛经历的反馈(例如,由于胸部炎症/压痛和胸部扩张)。PsA患者认为PROMs应包括有关他们所经历的尴尬和羞耻以及PsA对其日常生活影响的测量。

结论

这些定性评估结果表明,应更频繁地在门诊环境中纳入PROMs,以帮助改善患者与其医疗服务提供者之间决策对话的质量。参与者指出,孤立、抑郁、疲劳以及与他人的关系等结构对于让医疗专业人员了解患者的疾病生活经历至关重要。

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