Systematic surveillance of patient-reported symptoms of viral respiratory tract infectious Syndromes in diverse populations

Abstract

Background Patient reported outcome measures (PROM) can improve patient care and be crucial for symptom tracking especially during disease outbreaks. FLU-PRO Plus is a validated PROM used to track viral respiratory symptoms. Our study aimed to evaluate the feasibility of using FLU-PRO© Plus, to track symptoms across three healthcare systems. Methods The prospective, longitudinal study recruited adults between February-May 2021 from HealthPartners Institute (HP), Kaiser Permanente Georgia (KPGA), and Kaiser Permanente Mid-Atlantic States (KPMAS). Adult members were eligible if they had a positive lab or diagnosis for either COVID-19 or influenza-like illness (ILI) or exhibited 2 + viral respiratory symptoms. Descriptive statistics were calculated to describe the patient characteristics for participants that were eligible for FLU-PRO Plus, successfully contacted, attempted to log in to the FLU-PRO Plus website, and participants who completed FLU-PRO Plus Day 1. Bivariable and multivariable logistic regression using PROC GLIMMIXX investigated the patient characteristics associated with (1) successful contact and (2) FLU-PRO Plus Day 1 completion. Results We identified a total of 15,650 eligible participants during the enrollment period: 9,582 from HP, 1,740 from KPGA, and 4,328 from KPMAS. Among the total of 409 eligible adults who attempted to participate in FLU-PRO Plus, 317 completed FLU-PRO Plus Day 1. Among the 317 individuals that completed FLU-PRO Plus Day 1, 205 (67.5%) were diagnosed with COVID-19; 112 adults diagnosed with COVID-19 completed FLU-PRO Plus Day 14. Among adults successfully contacted, adults aged 35–64 (OR = 1.40, 95% CI 1.05, 1.87), females (OR = 1.77, 95% CI 1.38, 2.27), and adults diagnosed with COVID-19 (OR = 1.66, 95% CI 1.27, 2.17) had higher odds of completing FLU-PRO Plus Day 1; Asian adults (OR = 0.38, 95% CI 0.19, 0.76) and Black and African American adults (OR = 0.33, 95% CI 0.19, 0.76) had lower odds compared to White adults. Conclusion Our study reports on the feasibility of patients across three integrated healthcare systems utilizing FLU-PRO Plus to monitor their respiratory symptoms. Patient reported outcome measures (PROM) can improve patient care, quality of life, and reduce the strain of limited resources on healthcare systems. Future FLU-PRO Plus studies should develop an implementation strategy to fully integrate FLU-PRO Plus within clinical care and patient management.

Correction: Systematic surveillance of patient-reported symptoms of viral respiratory tract infectious Syndromes in diverse populations

“…The author group and list of affiliations has been updated above and the original article [1] has been corrected.…”

Factor Analysis in Distinguishing Coronavirus Disease 2019 From Other Influenza-like Illness Using a Validated Patient-Reported Outcome Instrument FLU-PRO Plus

“…As part of a multisite exploratory pilot study to assess the feasibility of implementing FLU-PRO Plus at the time of care, we administered the FLU-PRO Plus questionnaire in 3 community populations during the 2020-2021 "influenza season"-when ILI is typically prevalent and COVID-19 was concurrently prevalent in these same communities. While the larger study focused on measures of feasibility, 4 the data collected allowed for ancillary exploratory analyses using the FLU-PRO Plus results leading to the current work. Our study had 3 objectives:…”

“…As part of a multisite exploratory pilot study to assess the feasibility of implementing FLU-PRO Plus at the time of care, we administered the FLU-PRO Plus questionnaire in 3 community populations during the 2020–2021 “influenza season”—when ILI is typically prevalent and COVID-19 was concurrently prevalent in these same communities. While the larger study focused on measures of feasibility,4 the data collected allowed for ancillary exploratory analyses using the FLU-PRO Plus results leading to the current work. Our study had 3 objectives: To evaluate whether symptom scores derived from the factor structure of the FLU-PRO Plus questionnaire in the study sample might discriminate adults likely to have COVID-19 from those without a COVID-19 diagnosis and likely to have ILI; To assess the quality-of-life impact of symptom burden in the patient groups; and To examine whether progression from onset to the resolution of symptoms in the subgroups was similar or different in the patients with and without a COVID-19 diagnosis. …”