Division of Rheumatology/Department of Medicine, Tufts Medical Center.
Tufts Clinical and Translational Science Institute, Tufts University.
Rheumatology (Oxford). 2022 Nov 28;61(12):4763-4774. doi: 10.1093/rheumatology/keac200.
To assess the feasibility and impact of integrating electronic patient-reported outcome measures (PROMs) into the routine outpatient care of patients with SLE.
We conducted a prospective cohort study, utilizing a mixed-methods sequential explanatory design, of SLE outpatients receiving rheumatology care at two academic medical centres. Participants completed electronic PROMs at enrolment and then prior to their next two routine rheumatology visits. PROM score reports were shared with patients and rheumatologists before visits. Patients and rheumatologists completed post-visit surveys evaluating the utility of PROMs in the clinical encounters. Focus groups of patients and interviews with treating rheumatologists were conducted to further explore their experience utilizing PROMs.
A total of 105 SLE patients and 17 rheumatologists participated in the study. Patients completed PROMs in 159 of 184 encounters (86%), with 93% of surveys completed remotely. Patients reported that PROMs were 'quite a bit' or 'very' useful (55% of encounters) and beneficial to communication (55% of encounters). In contrast, physicians found PROMs useful (20%) and beneficial to communication (17%) less frequently. There was no significant change in visit length, health-related quality of life or disease activity after implementation of PROMs; however, patient satisfaction improved slightly. Qualitative analyses revealed that patients felt PROMs provided utility primarily by facilitating communication, particularly when physicians discussed the surveys.
The remote capture and integration of electronic PROMs into clinical care was feasible in a diverse cohort of SLE outpatients. PROMs were useful to patients and enhanced their clinical experience primarily by facilitating communication.
评估将电子患者报告结局测量（PROM）整合到 SLE 患者常规门诊护理中的可行性和影响。
我们开展了一项前瞻性队列研究，采用混合方法序贯解释设计，对在两家学术医疗中心接受风湿病学护理的 SLE 门诊患者进行研究。参与者在入组时和随后的两次常规风湿病学就诊前完成电子 PROM。在就诊前与患者和风湿病医生共享 PROM 评分报告。患者和风湿病医生在就诊后完成调查，评估 PROM 在临床就诊中的实用性。对患者进行焦点小组讨论，并对治疗风湿病的医生进行访谈，以进一步探讨他们使用 PROM 的经验。
共有 105 名 SLE 患者和 17 名风湿病医生参与了这项研究。患者在 184 次就诊中的 159 次（86%）完成了 PROM，其中 93%的调查是远程完成的。患者报告称，PROM“相当有用”或“非常有用”（55%的就诊），并且对沟通有帮助（55%的就诊）。相比之下，医生认为 PROM 更有用（20%），对沟通更有帮助（17%）的频率较低。在实施 PROM 后，就诊时间、健康相关生活质量或疾病活动度没有显著变化；然而，患者满意度略有提高。定性分析显示，患者认为 PROM 主要通过促进沟通提供了实用性，特别是当医生讨论调查时。
在多样化的 SLE 门诊患者队列中，远程采集和整合电子 PROM 纳入临床护理是可行的。PROM 对患者有用，并通过促进沟通主要增强了他们的临床体验。
