Patient Reported Outcome Measures for Patients With CKD: The Case for Patient Reported Outcomes Measurement Information System (PROMIS) Tools

Chronic kidney disease (CKD), kidney failure and kidney replacement therapies are associated with high symptom burden and impaired health-related quality-of-life (HRQOL). Symptoms change with disease progression, or transition between treatment modalities, and frequently go unreported and unmanaged. Tools that reliably monitor symptoms may improve management of patients with CKD. Patient-reported outcome measures (PROMs) assess symptom severity, physical, psychological, social and cognitive functioning, treatment-related side-effects, and HRQOL. Systematic use of PROMs can improve patient-provider communication, patient satisfaction, clinical outcomes, and HRQOL. Potential barriers to use include lack of engagement, response burden, and limited guidance about PROM collection, score interpretation and workflow integration. Well defined, acceptable and effective clinical response pathways are essential for implementing PROMs. PROMs developed by the Patient-Reported Outcomes Measurement Information System (PROMIS?) address some challenges and may be suitable for clinical use among patients with CKD. PROMIS tools assess multiple patient-valued, clinically actionable symptoms and functions. They can be administered as fixed-length, customized short-forms, or computer adaptive tests, offering precise measurement across a range of symptom severity or function levels, tailored questions to individuals, and reduced question burden. Here, we provide an overview of the potential use of PROMs in CKD care, with a focus on PROMIS.