Implementation of the PROMIS-29 in Routine Care for People With Diabetes

Abstract

Using patient-reported outcome measures (PROMs) in care planning has the potential to improve care, but information about routine implementation in settings serving disadvantaged groups is needed. Two primary care clinics serving populations predominantly eligible for Medicaid and diverse in race/ethnicity implemented the PROMIS-29 as part of clinical care planning. Of the target population with diabetes, 26% (n = 490) completed the PROMs; the proportion that set a goal based on the PROMs differed by site. This report describes factors influencing the PROMs process and the results of interviews with patients and members of the care team about PROMs' implementation and impact.

Variation and Change Over Time in PROMIS-29 Survey Results Among Primary Care Patients With Type 2 Diabetes

“…This study was conducted in two primary care organizations with diverse structures and patient populations (a Federally Qualified Health Center and an academic health center), previously described in detail. 16 This project was reviewed and approved by Chesapeake Research Review, LLC (Columbia, MD) and the institutional review boards at the participating sites. A waiver of consent was requested and approved for the provision of a limited data set that included necessary clinical data elements, PROM data, and goal-setting information collected during routine care.…”

“…12,13 Although patient-reported outcome tools are increasingly being used in routine clinical care, there are challenges to implementation and interpretation for patients with complex chronic conditions. 10,[14][15][16] Information regarding how to interpret results, the amount of change to expect over time, and how to maintain or improve functioning or forestall slow decline is inadequate. 17 There is growing evidence of the validity of Patient-Reported Outcomes Measurement Information System (PROMIS ® ) tools over time with some clinical populations, 18,19 yet data for patients with diabetes is lacking.…”

DiabetesFlex™ – the effect of PRO-based telehealth and user involvement in care management of patients with type 1 diabetes: Trial protocol for a non-inferiority randomised controlled study

“…8 The use of PRO in routine clinical care for patients with diabetes is limited as PRO measures in diabetes care are mostly used as a screening tool and in research. 12 . Still, studies show that the use of PRO influences the care and can be valuable for both the care team and the patient with diabetes as the use of PRO allows the patients to report systematically on symptoms and provide healthcare professionals with a better insight of the patient's perceptions of their health and their disease.…”

“…Still, studies show that the use of PRO influences the care and can be valuable for both the care team and the patient with diabetes as the use of PRO allows the patients to report systematically on symptoms and provide healthcare professionals with a better insight of the patient's perceptions of their health and their disease. 12 . This is consistent with additional studies including patients with other chronic conditions, which demonstrate how use of PRO in routine care can be an effective way for healthcare professionals to understand the patient's perspective on the disease, including psychosocial and behavioural problems, support individualisation of treatment, optimise communication and monitor the effect of treatment.…”

“…This is consistent with additional studies including patients with other chronic conditions, which demonstrate how use of PRO in routine care can be an effective way for healthcare professionals to understand the patient's perspective on the disease, including psychosocial and behavioural problems, support individualisation of treatment, optimise communication and monitor the effect of treatment. 10,[12][13][14] . Patient-initiated follow-up may increase patient involvement as it allows patients to have a central position in care planning.…”