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Abstract: SA-PO1128

Real-World Utilization of a Patient-Reported Outcome (PRO) Assessment Tool in Nephrology Clinic: Patient and Provider Perspectives

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Patel, Dipal M., The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Stephens, Mary Ann Chutuape, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Gotay-Lehmer, Jessica M., The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Riekert, Kristin, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Crews, Deidra C., The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Background

Patient-reported outcome (PRO) assessment is a key component of person-centered care; however, approaches for utilizing PRO assessment tools in nephrology clinic are understudied. We integrated a PRO assessment tool into the electronic health record at Johns Hopkins (JH) and distributed it to people with CKD G3-5 prior to nephrology follow-up appointments. We evaluated determinants of patient and provider utilization of the PRO assessment tool.

Methods

We conducted surveys and individual semi-structured interviews of nephrology providers and people with CKD. We quantified questionnaire responses using descriptive statistics and performed thematic analysis of semi-structured interview transcripts.

Results

We surveyed 17 JH nephrology providers and 102 JH CKD patients. Answering Likert-scale questions (1=strongly disagree, 5=strongly agree), patients more strongly agreed with a need for symptom assessment compared to providers (mean ± S.D.: 3.9 ± 0.7 for providers and 4.5 ± 0.5 for patients, p < 0.01). Patients also more strongly agreed that PRO assessment tools would make patients “feel heard and understood” (mean ± S.D.: 3.5 ± 0.6 for providers and 4.2 ± 0.7 for patients, p < 0.01). Providers were uncertain if they would independently review and discuss PRO assessment tool scores during each clinic visit (mean ± S.D.: 2.6 ± 0.9). From semi-structured interviews of 15 providers and 21 patients, we identified key themes influencing utilization of the PRO assessment tool (Figure).

Conclusion

While the importance of PRO assessment is recognized by people with CKD and nephrology providers, we identified several barriers which should be addressed in order to improve the capability, opportunity, and motivation of care teams to incorporate PRO assessment tools into routine clinical care.

Themes and exemplary quotations.

Funding

  • Other NIH Support