Patient and clinician perspectives on electronic patient-reported outcome measures in the management of advanced CKD: a qualitative study

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@article{28f7368609644f70b447aae996b247c6,
title = "Patient and clinician perspectives on electronic patient-reported outcome measures in the management of advanced CKD: a qualitative study",
abstract = "RATIONALE & OBJECTIVE: Chronic kidney disease (CKD) can substantially affect patients' health-related quality of life. Electronic patient-reported outcome measures (ePROMs) may capture symptoms and health-related quality of life and assist in the management of CKD. This study explored patient and clinician views on the use of a renal ePROM system.STUDY DESIGN: Qualitative study.SETTING & PARTICIPANTS: 12 patients with stage 4 or 5 CKD (non-dialysis dependent); 22 clinicians (6 CKD community nurses, 1 clinical psychologist, 10 nephrologists, 3 specialist registrars, and 2 renal surgeons) in the United Kingdom.ANALYTICAL APPROACH: Semi-structured interviews and focus group discussion during which patients received paper versions of the Kidney Disease Quality of Life-36 and the Integrated Patient Outcome Scale-Renal to exemplify the type of content that could be included in an ePROM. Thematic analysis of interview transcripts.RESULTS: 4 themes were identified: (1) general opinions of PROMs, (2) potential benefits and applications of an ePROM system, (3) practical considerations for the implementation of ePROMs, and (4) concerns, barriers, and facilitators. Patients were willing to complete ePROMs on a regular basis as part of their care despite clinician concerns about patient burden. Patients assessed the questionnaires favorably. Clinicians suggested that the extent of adoption of renal ePROM systems in routine clinical settings should be based on evidence of significant impact on patient outcomes. Clinicians were concerned that an ePROM system may raise patient expectations to unrealistic levels and expose clinicians to the risk for litigation. Patients and clinicians identified potential benefits and highlighted issues and concerns that need to be addressed to ensure the successful implementation of the renal ePROM system.LIMITATIONS: Transferability of the findings may be limited because only English-speaking participants were recruited to the study.CONCLUSIONS: A renal ePROM system may play a supportive role in the routine clinical management of patients with advanced CKD if the concerns of clinicians and patients can be sufficiently addressed.",
keywords = "CKD, Chronic kidney disease, HRQOL, PRO, QOL, chronic renal failure, doctor-patient communication, ePROM, electronic patient-reported outcome measures, focus group, health-related quality of life, interview, nephrology practice, patient-reported outcome, qualitative research, renal disease",
author = "Aiyegbusi, {Olalekan Lee} and Derek Kyte and Paul Cockwell and Tom Marshall and Mary Dutton and Natalie Walmsley-Allen and Anita Slade and Christel McMullan and Melanie Calvert",
note = "Copyright {\textcopyright} 2019 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.",
year = "2019",
month = aug,
doi = "10.1053/j.ajkd.2019.02.011",
language = "English",
volume = "74",
pages = "167--178",
journal = "American Journal of Kidney Diseases",
issn = "0272-6386",
publisher = "Elsevier",
number = "2",

}

RIS

TY - JOUR

T1 - Patient and clinician perspectives on electronic patient-reported outcome measures in the management of advanced CKD

T2 - a qualitative study

AU - Aiyegbusi, Olalekan Lee

AU - Kyte, Derek

AU - Cockwell, Paul

AU - Marshall, Tom

AU - Dutton, Mary

AU - Walmsley-Allen, Natalie

AU - Slade, Anita

AU - McMullan, Christel

AU - Calvert, Melanie

N1 - Copyright © 2019 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2019/8

Y1 - 2019/8

N2 - RATIONALE & OBJECTIVE: Chronic kidney disease (CKD) can substantially affect patients' health-related quality of life. Electronic patient-reported outcome measures (ePROMs) may capture symptoms and health-related quality of life and assist in the management of CKD. This study explored patient and clinician views on the use of a renal ePROM system.STUDY DESIGN: Qualitative study.SETTING & PARTICIPANTS: 12 patients with stage 4 or 5 CKD (non-dialysis dependent); 22 clinicians (6 CKD community nurses, 1 clinical psychologist, 10 nephrologists, 3 specialist registrars, and 2 renal surgeons) in the United Kingdom.ANALYTICAL APPROACH: Semi-structured interviews and focus group discussion during which patients received paper versions of the Kidney Disease Quality of Life-36 and the Integrated Patient Outcome Scale-Renal to exemplify the type of content that could be included in an ePROM. Thematic analysis of interview transcripts.RESULTS: 4 themes were identified: (1) general opinions of PROMs, (2) potential benefits and applications of an ePROM system, (3) practical considerations for the implementation of ePROMs, and (4) concerns, barriers, and facilitators. Patients were willing to complete ePROMs on a regular basis as part of their care despite clinician concerns about patient burden. Patients assessed the questionnaires favorably. Clinicians suggested that the extent of adoption of renal ePROM systems in routine clinical settings should be based on evidence of significant impact on patient outcomes. Clinicians were concerned that an ePROM system may raise patient expectations to unrealistic levels and expose clinicians to the risk for litigation. Patients and clinicians identified potential benefits and highlighted issues and concerns that need to be addressed to ensure the successful implementation of the renal ePROM system.LIMITATIONS: Transferability of the findings may be limited because only English-speaking participants were recruited to the study.CONCLUSIONS: A renal ePROM system may play a supportive role in the routine clinical management of patients with advanced CKD if the concerns of clinicians and patients can be sufficiently addressed.

AB - RATIONALE & OBJECTIVE: Chronic kidney disease (CKD) can substantially affect patients' health-related quality of life. Electronic patient-reported outcome measures (ePROMs) may capture symptoms and health-related quality of life and assist in the management of CKD. This study explored patient and clinician views on the use of a renal ePROM system.STUDY DESIGN: Qualitative study.SETTING & PARTICIPANTS: 12 patients with stage 4 or 5 CKD (non-dialysis dependent); 22 clinicians (6 CKD community nurses, 1 clinical psychologist, 10 nephrologists, 3 specialist registrars, and 2 renal surgeons) in the United Kingdom.ANALYTICAL APPROACH: Semi-structured interviews and focus group discussion during which patients received paper versions of the Kidney Disease Quality of Life-36 and the Integrated Patient Outcome Scale-Renal to exemplify the type of content that could be included in an ePROM. Thematic analysis of interview transcripts.RESULTS: 4 themes were identified: (1) general opinions of PROMs, (2) potential benefits and applications of an ePROM system, (3) practical considerations for the implementation of ePROMs, and (4) concerns, barriers, and facilitators. Patients were willing to complete ePROMs on a regular basis as part of their care despite clinician concerns about patient burden. Patients assessed the questionnaires favorably. Clinicians suggested that the extent of adoption of renal ePROM systems in routine clinical settings should be based on evidence of significant impact on patient outcomes. Clinicians were concerned that an ePROM system may raise patient expectations to unrealistic levels and expose clinicians to the risk for litigation. Patients and clinicians identified potential benefits and highlighted issues and concerns that need to be addressed to ensure the successful implementation of the renal ePROM system.LIMITATIONS: Transferability of the findings may be limited because only English-speaking participants were recruited to the study.CONCLUSIONS: A renal ePROM system may play a supportive role in the routine clinical management of patients with advanced CKD if the concerns of clinicians and patients can be sufficiently addressed.

KW - CKD

KW - Chronic kidney disease

KW - HRQOL

KW - PRO

KW - QOL

KW - chronic renal failure

KW - doctor-patient communication

KW - ePROM

KW - electronic patient-reported outcome measures

KW - focus group

KW - health-related quality of life

KW - interview

KW - nephrology practice

KW - patient-reported outcome

KW - qualitative research

KW - renal disease

UR - http://www.scopus.com/inward/record.url?scp=85064246154&partnerID=8YFLogxK

U2 - 10.1053/j.ajkd.2019.02.011

DO - 10.1053/j.ajkd.2019.02.011

M3 - Article

C2 - 31003865

VL - 74

SP - 167

EP - 178

JO - American Journal of Kidney Diseases

JF - American Journal of Kidney Diseases

SN - 0272-6386

IS - 2

ER -