Use of Electronic Patient Reported Outcomes in Clinical Nephrology Practice: A Qualitative Pilot Study

Schick‐Makaroff, Kara; Tate, Kaitlyn; Molzahn, Anita

doi:10.1177/2054358119879451

Cited by 17 publications

(27 citation statements)

References 38 publications

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“…The use of the ESAS‐r has been reported to improve patient‐focused assessment and facilitate monitoring of symptoms and taking management actions in patients on dialysis . PROMs such as the ESAS‐r are central to patient‐centered care as they harness the patient voice and perspectives and improve patient‐clinician communication .…”

Section: Discussionmentioning

confidence: 99%

“…Since the ESAS‐r is used among patients on dialysis in multiple jurisdictions, it may provide the opportunity for longitudinal follow‐up of symptoms in patients with various stages of chronic kidney disease (CKD), improving continuity of care . The use of the ESAS‐r in clinical care may improve patient–physician communication, may facilitate better understanding of underlying medical or psychosocial factors potentially linked to symptom experience, and may help identify patients who benefit from additional assessment or support . If validity and utility is confirmed, the ESAS‐r could also be used in clinical studies to follow patients with ESKD through various stages of the CKD trajectory and allow clinicians to develop a better understanding of the evolution of their symptom burden.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

et al. 2020

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Summary We assessed the validity of the Edmonton Symptom Assessment System (ESAS‐r) in kidney transplant recipients (KTR). A cross‐sectional sample of 252 KTR was recruited. Individual ESAS‐r symptom scores and symptom domain scores were evaluated. Internal consistency, convergent validity, and construct validity were assessed with Cronbach’s α, Spearman’s rank correlations, and a priori‐defined risk group comparisons. Mean (SD) age was 51 (16), 58% were male, and 58% Caucasian. ESAS‐r Physical, Emotional, and Global Symptom Scores demonstrated good internal consistency (α > 0.8 for all). ESAS‐r Physical and Global Symptom Scores strongly correlated with PHQ‐9 scores (0.72, 95% CI: 0.64–0.78 and 0.74, 95% CI: 0.67–0.80). For a priori‐defined risk groups, individual ESAS‐r symptom score differed between groups with lower versus higher eGFR [pain: 1 (0–3) vs. 0 (0–2), delta = 0.18; tiredness: 3 (1–5) vs. 1.5 (0–4), delta = 0.21] and lower versus higher hemoglobin [tiredness: 3 (1–6) vs. 2 (0–4), delta = 0.27]. ESAS‐r Global and Physical Symptom Scores differed between groups with lower versus higher hemoglobin [13 (6–29) vs. 6.5 (0–18.5), delta = 0.3, and 9 (2–19) vs. 4 (0–13), delta = 0.24] and lower versus higher eGFR [11 (4–20) vs. 6.5 (2–13), delta = 0.21, and 7 (2–16) vs. 3 (0–9), delta = 0.26]. These data support reliability and construct validity of ESAS‐r in KTR. Future studies should explore its clinical utility for symptom assessment among KTR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

et al. 2020

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“… 81 The use of ePROMs in the management of patients receiving home dialysis is also being trialled in the ePRO Kidney study. 82 …”

Section: Ongoing Eprom Initiativesmentioning

confidence: 99%

A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases

Aiyegbusi

Nair

Peipert

et al. 2021

Therapeutic Advances in Chronic Disease

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An application of telemedicine of growing interest and relevance is the use of personal computers and mobile devices to collect patient-reported outcomes (PROs). PROs are self-reports of patients’ health status without interpretation by anyone else. The tools developed to assess PROs are known as patient-reported outcomes measures (PROMs). The technological innovations that have led to an increased ownership of electronic devices have also facilitated the development of electronic PROMs (ePROMs). ePROMs are a conduit for telemedicine in the care of patients with chronic diseases. Various studies have demonstrated that the use of ePROMs in routine clinical practice is both acceptable and feasible with patients increasingly expressing a preference for an electronic mode of administration. There is increasing evidence that the use of electronic patient-reported outcome (ePROMs) could have significant impacts on outcomes valued by patients, healthcare providers and researchers. Whilst the development and implementation of these systems may be initially costly and resource-intensive, patient preferences and existing evidence to support their implementation suggests the need for continued research prioritisation in this area. This narrative review summarises and discusses evidence of the impact of ePROMs on clinical parameters and outcomes relevant to chronic diseases. We also explore recently published literature regarding issues that may influence the robust implementation of ePROMs for routine clinical practice.

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“…However, there was no significant difference measured for HRQOL or improvement in home dialysis care [19]. Another study examining the use of electronic PROs in patients receiving home dialysis care found that electronic PROs were useful for obtaining information that allowed for better person-centered care and clinicians asked more questions about symptoms and were more involved [9]. However, the study was unable to determine whether the intervention would be better than usual care, necessitating more research in this area.…”

Section: Integration Of the Patient Perspective With Technologymentioning

confidence: 99%

“…There are not enough strategies to assist health-care providers in the use of PRO measures when evaluating kidney care. One approach aims to address PROs with the use of a realist synthesis approach, looking at a wide range of data, to create a kidney-specific program theory to optimize the use of PROs on individual and aggregate levels of patient-centered care [9]. There has also been a push toward collecting PROs electronically directly from the patients, and now, with a push toward telemedicine because of the COVID-19 pandemic, EHRs may become the best mode of communication between physician and patient.…”

Section: Measurement Of Pro In Patients With Kidney Diseasementioning

confidence: 99%

Using Patient-Reported Measures to Improve Outcomes in Kidney Disease

2021

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Patients with CKD and ESRD are vulnerable to increased mortality rates and other poor outcomes. Among those with ESRD, their health-related quality of life (HRQOL) is shown little to no improvement as they undergo treatments such as dialysis and providers concurrently manage other health issues that complicate their already vulnerable state. This review synthesizes evidence demonstrating that a focus on measuring and monitoring patient-reported outcomes (PRO) such as pain and depression can improve HRQOL. Patient-centered care has the potential to create an efficient way for clinicians to address specific challenges facing patients. While there is an emerging literature assessing the use of PROs in kidney research, by examining relevant research in other disciplines it is possible to generate better ways to use PROs in this high-risk population. Electronic health records as well as various other electronic methods of communication between the clinician and patient may serve to accelerate the trajectory toward patient-centered care using PROs.

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Use of Electronic Patient Reported Outcomes in Clinical Nephrology Practice: A Qualitative Pilot Study

Cited by 17 publications

References 38 publications

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases

Using Patient-Reported Measures to Improve Outcomes in Kidney Disease

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