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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Evaluation of real-time use of electronic patient-reported outcome data by nurses with patients in home dialysis clinics

Authors: Kara Schick-Makaroff, Anita E. Molzahn

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Internationally, the use of patient-reported outcomes (PROs) is increasing. Electronic PROs (ePROs) offer immediate access of such reports to healthcare providers. The objectives of this study were to assess nurses’ perspectives on the usefulness and impact of ePRO administration in home dialysis clinics and assess patient perceptions of satisfaction with nursing care following use of ePROs.

Methods

A concurrent, longitudinal, mixed methods study was conducted over 6 months during home dialysis outpatient clinic visits in two cities. Patients (n = 99) provided ePROs using tablet computers when they visited the clinic on two consecutive occasions approximately 3 months apart. Results were scored, printed, and given to nurses before patient appointments. Patients completed satisfaction items from the Comox Valley Nursing Centre Client questionnaire following their appointments. All clinic nurses (n = 11) participated and they were each interviewed twice, three months and six months after the start of the study.

Results

The five themes that emerged from the interviews with the nurses include: enhancing focus of the nurses, directing interdisciplinary follow-up, offering support to patients through the process, interpreting results from the visual display, and integrating into workflow.
Scores on the Client Questionnaire suggested that patients believed that they received excellent care (97%), and that the nurses perfectly understood their needs (90.9%). However, their satisfaction with care did not change over time when ePRO data was repeatedly provided to their nurses.

Conclusions

Nurses reported that sharing ePRO data in real-time informed their practice. Although there was no statistically significant change in patient satisfaction scores over time, some patients reported changes and benefits from the use of ePROs. Further research is needed to provide guidance about how ePRO data could enhance person-centered care.
Literature
1.
2.
Canadian Institute for Health Information (CIHI). CIHI PROMs forum: PROMs background document. Ottawa: ON: CIHI; 2015.
3.
Hjollund NHI, Larsen LP, Biering K, Johnsen SP, Riiskjaer E, Schougaard LM. Use of patient-reported outcome (PRO) measures at group and patient levels: experience from the generic integrated PRO system. WestChronic Interact J Med Res. 2014;3(1):e5. doi:10.​2196/​ijmr.​2885.CrossRefPubMed
4.
Basch E, Goldfarb S. Electronic patient-reported outcomes for collecting sensitive information from patients. J Support Oncol. 2009;7:98–9.PubMed
5.
Dupont A, Wheeler J, Herndon JE II, Coan A, Zafar SY, Hood L, et al. Use of tablet personal computers for sensitive patient-reported information. J Support Oncol. 2009;7:91–7.PubMed
6.
Smith SK, Rowe K, Abernethy AP. Use of an electronic patient-reported outcome measurement system to improve distress management in oncology. Palliat Support Care. 2014;12:69–73.CrossRefPubMed
7.
Zbrozek A, Hebert J, Gogates G, Thorell R, Dell C, Molsen E, et al. Validation of electronic systems to collect patient-reported outcome (PRO) data – recommendations for clinical trial teams: report of the ISPOR ePRO systems validation good research practices task force. Value Health. 2013;16:48–489.CrossRef
8.
Schick-Makaroff K, Molzahn A. Strategies to use tablet computers for collection of electronic patient-reported outcomes. Health Qual Life Out. 2015;13(1, 2) doi:10.​1186/​s12955-014-0205-1.
9.
Bennett AV, Jensen RE, Basch E. Electronic patient-reported outcome systems in oncology clinical practice. CA-Cancer J Clin. 2012;62:337–47.CrossRefPubMed
10.
Hilarius DL, Kloeg PH, Gundy CM, Aaronson NK. Use of health-related quality-of-life assessments in daily clinical oncology nursing practice: a community hospital-based intervention study. Cancer. 2008;113:628–37.CrossRefPubMed
11.
Velikova G, Booth L, Smith AB, Brown PM, Lynch P, Brown JM, et al. Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized control trial. J Clin Oncol. 2004;22:714–24.CrossRefPubMed
12.
Dy SM, Roy J, Ott GE, McHale M, Kennedy C, Kutner JS, et al. Tell us™: a web-based tool for improving communication among patients, families, and providers in hospice and palliative care through systematic data specification, collection and use. J Pain Symptom Manag. 2011;42:526–34.CrossRef
13.
Wolpert M, Curtis-Tyler K, Edbrooke-Childs J. A qualitative exploration of patient and clinician views on patient reported outcome measures in child mental health and diabetes services. Adm Policy Ment Health. 2014; doi: 10.​1007/​s10488-014-0586-9
14.
15.
Greenhalgh J. The applications of PROs in clinical practice: what are they, do they work, and why? Qual Life Res. 2009;18:115–23.CrossRefPubMed
16.
Greenhalgh J, Abhyankar P, McCluskey S, Takeuchi E, Velikova G. How do doctors refer to patient-reported outcome measures (PROMS) in oncology consultations? Qual Life Res. 2013;22:939–50.CrossRefPubMed
17.
Edbrooke-Childs J, Wolpert M, Deighton J. Using patient reported outcome measures to improve service effectiveness (UPROMISE): Training clinicians to use outcome measures in child mental health. Adm Policy Ment Health. 2014; doi: 10.​1007/​s10488-014-0600-2.
18.
Takeuchi EE, Keding A, Awad N, Hofmann U, Campbell LJ, Selby PJ, et al. Impact of patient-reported outcomes in oncology: a longitudinal analysis of patient-physician communication. J Clin Oncol. 2011;29:2910–7.CrossRefPubMed
19.
Kumnig M, Rumpold G, Höfer S, König P, Holzner B, Giesinger J, et al. Patient-reported outcome reference values for patients after kidney transplantation. Wien Klin Wochenschr. 2014;126:15–22.CrossRefPubMed
20.
Purnell TS, Auguste P, Crews DC, Lamprea-Montealegre J, Olufade T, Greer R, et al. Comparison of life participation activities among adults treated by hemodialysis, peritoneal dialysis, and kidney transplantation: a systematic review. Am J Kidney Dis. 2013;62:953–573.CrossRefPubMed
21.
Snyder CF, Aaronson NK, Choucair AK, Elliott TE, Greenhalgh J, Halyard MY, et al. Implementing patient-reported outcomes assessment in clinical practice: a review of the options and considerations. Qual Life Res. 2012;21:1305–14.CrossRefPubMed
22.
Finkelstein FO, Wuerth D, Finkelstein SH. Health related quality of life and the CKD patient: challenges for the nephrology community. Kidney Int. 2009;76:946–52.CrossRefPubMed
23.
24.
Cavanaugh KL. Prioritizing patient-centered care implementation and research for patients with kidney disease. Sem Dialysis. 2014; doi: 10.​1111/​sdi.​12326.
25.
Manns B, Hemmelgarn B, Lillie E, Crowe S, Cyr A, Gladish M, et al. Setting research priorities for patients on or nearing dialysis. Clin J Am Soc Nephrol. 2014;9:1813–21.CrossRefPubMedPubMedCentral
26.
Perrone RD, Coons SJ, Cavanaugh K, Finkelstein F, Meyer KB. Patient-reported outcomes in clinical trials of CKD-related therapies: report of a symposium sponsored by the National Kidney Foundation and the US Food and Drug Administration. Am J Kidney Dis. 2013;62:1046–57.CrossRefPubMed
27.
Krishnan M, Brunelli SM, Maddux FW, Parker TF, Johnson D, Nissenson AR, et al. Guiding principles and checklist for population-based quality metrics. Clin J Am Soc Nephrol. 2014;9:1124–31.CrossRefPubMedPubMedCentral
28.
Klassen AC, Cresswell J, Plano Clark VL, Smith KC, Meissner HI. Best practices in mixed methods for quality of life research. Qual Life Res. 2012;21:377–80.CrossRefPubMed
29.
Creswell JW. Mapping the developing landscape of mixed methods research. In: Tashakkori A, Teddlie C, editors. The sage handbook of mixed methods in social and behavioral research. 2nd ed. Thousand Oaks: Sage; 2010. p. 1–44.
30.
31.
Eduardo B, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton symptom assessment system (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991;7:6–9.
32.
Davison SN, Jhandri GS, Johnson JA. Cross-sectional validity of a modified Edmonton symptom assessment system in dialysis patients: a simple assessment of symptom burden. Kidney Int. 2006;69:1621–5.CrossRefPubMed
33.
Davison SN, Jhandri GS, Johnson JA. Longitudinal validation of a modified Edmonton symptom assessment system (ESAS) in haemodialysis patients. Nephrol Dial Transpl. 2006;21:3189–95.CrossRef
34.
Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB. Development of the kidney disease quality of life (KDQOL) instrument. Qual Life Res. 1994;3:329–38.CrossRefPubMed
35.
Hilton BA, Budgen C, Mozahn AE, Attridge CB. Developing and testing instruments to measure client outcomes at the Comox Valley nursing center. Public Health Nurs. 2001;18:327–39.CrossRefPubMed
36.
37.
Coons SJ, Gwaltney CJ, Hays RD, Lundy JJ, Sloan JA, Revicki DA, et al. Recommendations on evidence needed to support measurement equivalence between electronic and paper-based patient-reported outcome (PRO) measures: ISPOR ePRO good research practices task force report. Value Health. 2009;12:419–29.CrossRefPubMed
38.
Thorne S. Interpretive description. Walnut Creek: Left Coast Press; 2007.
39.
Sandelowski M, Barroso J. Classifying the findings in qualitative studies. Qual Health Res. 2003;13:905–23.CrossRefPubMed
40.
Noble H, Kelly D, Rawlings-Anderson K, Meyer J. A concept analysis of renal supportive care: the changing world of nephrology. J Adv Nurs. 2007;59:644–53.CrossRefPubMed
41.
Ivanitskaya L, Clark D, Montgomery G, Primeau R. Interdisciplinary learning: process and outcomes. Innov Higher Educ. 2002;27:95–111.CrossRef
42.
Greenhalgh J, Long AF, Flynn R. The use of patient reported outcome measures in routing clinical practice: lack of impact or lack of theory? Soc Sci Med. 2005;62:833–43.CrossRef
43.
Marshall S, Haywood KL, Fitzpatrick R. Impact of patient-reported outcome measures on routine practice: a structured review. J Eval Clin Pract. 2006;12:559–68.CrossRefPubMed
44.
Taenzer P, Bultz BD, Carlson LE, Speca M, DeGagne T, Olson K, et al. Impact of computerized quality of life screening on physician behaviour and patient satisfaction in lung cancer outpatients. Psychooncology. 2000;9:203–13.CrossRefPubMed
45.
Schick-Makaroff K, Sheilds L, Molzahn A. Stories of chronic kidney disease: listening for the unsayable. J Adv Nurs. 2013;69:2644–53.CrossRef
46.
Schick-Makaroff K, Sheilds L, Molzahn A. Symbolic representations of living with chronic kidney disease. Nephrol Nurs J. 2013;40:517–26.
47.
Holzner B, Giesinger JM, Pinggera J, Zugal S, Schöpf F, Oberguggenberger AS, et al. The computer-based health evaluation software (CHES): a software for electronic patient-reported outcome monitoring. BMC Med Inform Decis Mak. 2012;9:126–37.CrossRef
48.
Chang Y-J, Chang C-H, Peng C-L, Wu H-C, Lin H-C, Wang J-Y, et al. Measurement equivalence and feasibility of the EORTC QLQ-PR25: paper-and-pencil versus touch-screen administration. Health Qual Life Out. 2014;12(1):23. doi:10.​1186/​1477-7525-12-23.CrossRef
49.
Coons SJ. ePRO systems validation: clearly defining the roles of clinical trial teams and ePRO system providers. Value Health. 2013;16:457–8.CrossRefPubMed
50.
Ashley L, Jones H, Forman D, Newsham A, Brown J, Downing A, et al. Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: the electronic patient-reported outcomes from cancer survivors (ePOCS) system. BMC Med Inform Decis Mak. 2011;11(1):66. doi:10.​1186/​1472-6947-11-66.CrossRefPubMedPubMedCentral
Metadata
Title
Evaluation of real-time use of electronic patient-reported outcome data by nurses with patients in home dialysis clinics
Authors
Kara Schick-Makaroff
Anita E. Molzahn
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2377-y

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