Esteban Rubio, Mª José Moreno, Adela Gallego, Isabel Castrejón, Amelia Cobo, Sebastián Moyano, Marta Comellas
{"title":"在西班牙类风湿关节炎患者中使用患者报告的结果测量方法和实施障碍：德尔菲研究。","authors":"Esteban Rubio, Mª José Moreno, Adela Gallego, Isabel Castrejón, Amelia Cobo, Sebastián Moyano, Marta Comellas","doi":"10.1007/s12325-025-03300-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the pattern of use and barriers for implementation of patient-reported outcomes measures (PROMs) in patients with rheumatoid arthritis (RA) in Spain.</p><p><strong>Methods: </strong>Two-round Delphi study targeted at rheumatologists attending a PROMs training program and guided by a Scientific Committee composed of four expert rheumatologists was conducted. The survey assessed the current use, appropriateness, and feasibility of 7 PROMs proposed by the International Consortium for Health Outcomes Measurements (ICHOM). Barriers to implement PROMs in routine care were also explored. A 7-point Likert scale was used ranging from 1 (strongly disagree) to 7 (strongly agree). Consensus was established when > 75% reached agreement (rated 6-7 = agreement, or 1-2 = disagreement).</p><p><strong>Results: </strong>A total of 39 rheumatologists of 120 (32%) participated {61.5% women; mean age 50.3 [standard deviation (SD) 11.0] years; mean 18.1 (9.6) years of experience; 23.1% running a RA clinic}. Although 82.1% of rheumatologists agreed on involving patients in shared decision-making (SDM), only 56.4% adopted SDM strategies in treatment decisions. A higher percentage (79.4%) agreed on the importance of incorporating PROMs, but only 28.2% recognized to use them in routine care, being the most frequently used pain on a visual analogue scale (VAS) (89.8%), the Health Assessment Questionnaire (HAQ) (71.7%), and a VAS-fatigue (66.7%). The remaining proposed PROMs by ICHOM did not reach a consensus on either appropriateness or feasibility. The main barriers found included lack of time in consultation (84.6%) and the unavailability of PROMs platforms incorporated in the electronic medical records (87.9%).</p><p><strong>Conclusion: </strong>Spanish rheumatologists consider PROMs useful to guide SDM in routine care being the most frequently used pain, fatigue, and physical function. However, other domains proposed by ICHOM as health-related quality of life (HRQoL) or work/school productivity are not commonly used. Promoting the use of PROMs strategies, including optimizing consultation time and incorporating PROMs into electronic medical records, is necessary.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of Patient-Reported Outcome Measures in Patients with Rheumatoid Arthritis in Spain and Barriers to Implementation: A Delphi Study.\",\"authors\":\"Esteban Rubio, Mª José Moreno, Adela Gallego, Isabel Castrejón, Amelia Cobo, Sebastián Moyano, Marta Comellas\",\"doi\":\"10.1007/s12325-025-03300-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study aimed to investigate the pattern of use and barriers for implementation of patient-reported outcomes measures (PROMs) in patients with rheumatoid arthritis (RA) in Spain.</p><p><strong>Methods: </strong>Two-round Delphi study targeted at rheumatologists attending a PROMs training program and guided by a Scientific Committee composed of four expert rheumatologists was conducted. The survey assessed the current use, appropriateness, and feasibility of 7 PROMs proposed by the International Consortium for Health Outcomes Measurements (ICHOM). Barriers to implement PROMs in routine care were also explored. A 7-point Likert scale was used ranging from 1 (strongly disagree) to 7 (strongly agree). Consensus was established when > 75% reached agreement (rated 6-7 = agreement, or 1-2 = disagreement).</p><p><strong>Results: </strong>A total of 39 rheumatologists of 120 (32%) participated {61.5% women; mean age 50.3 [standard deviation (SD) 11.0] years; mean 18.1 (9.6) years of experience; 23.1% running a RA clinic}. Although 82.1% of rheumatologists agreed on involving patients in shared decision-making (SDM), only 56.4% adopted SDM strategies in treatment decisions. A higher percentage (79.4%) agreed on the importance of incorporating PROMs, but only 28.2% recognized to use them in routine care, being the most frequently used pain on a visual analogue scale (VAS) (89.8%), the Health Assessment Questionnaire (HAQ) (71.7%), and a VAS-fatigue (66.7%). The remaining proposed PROMs by ICHOM did not reach a consensus on either appropriateness or feasibility. The main barriers found included lack of time in consultation (84.6%) and the unavailability of PROMs platforms incorporated in the electronic medical records (87.9%).</p><p><strong>Conclusion: </strong>Spanish rheumatologists consider PROMs useful to guide SDM in routine care being the most frequently used pain, fatigue, and physical function. However, other domains proposed by ICHOM as health-related quality of life (HRQoL) or work/school productivity are not commonly used. Promoting the use of PROMs strategies, including optimizing consultation time and incorporating PROMs into electronic medical records, is necessary.</p>\",\"PeriodicalId\":7482,\"journal\":{\"name\":\"Advances in Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-07-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Advances in Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12325-025-03300-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12325-025-03300-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Use of Patient-Reported Outcome Measures in Patients with Rheumatoid Arthritis in Spain and Barriers to Implementation: A Delphi Study.
Introduction: This study aimed to investigate the pattern of use and barriers for implementation of patient-reported outcomes measures (PROMs) in patients with rheumatoid arthritis (RA) in Spain.
Methods: Two-round Delphi study targeted at rheumatologists attending a PROMs training program and guided by a Scientific Committee composed of four expert rheumatologists was conducted. The survey assessed the current use, appropriateness, and feasibility of 7 PROMs proposed by the International Consortium for Health Outcomes Measurements (ICHOM). Barriers to implement PROMs in routine care were also explored. A 7-point Likert scale was used ranging from 1 (strongly disagree) to 7 (strongly agree). Consensus was established when > 75% reached agreement (rated 6-7 = agreement, or 1-2 = disagreement).
Results: A total of 39 rheumatologists of 120 (32%) participated {61.5% women; mean age 50.3 [standard deviation (SD) 11.0] years; mean 18.1 (9.6) years of experience; 23.1% running a RA clinic}. Although 82.1% of rheumatologists agreed on involving patients in shared decision-making (SDM), only 56.4% adopted SDM strategies in treatment decisions. A higher percentage (79.4%) agreed on the importance of incorporating PROMs, but only 28.2% recognized to use them in routine care, being the most frequently used pain on a visual analogue scale (VAS) (89.8%), the Health Assessment Questionnaire (HAQ) (71.7%), and a VAS-fatigue (66.7%). The remaining proposed PROMs by ICHOM did not reach a consensus on either appropriateness or feasibility. The main barriers found included lack of time in consultation (84.6%) and the unavailability of PROMs platforms incorporated in the electronic medical records (87.9%).
Conclusion: Spanish rheumatologists consider PROMs useful to guide SDM in routine care being the most frequently used pain, fatigue, and physical function. However, other domains proposed by ICHOM as health-related quality of life (HRQoL) or work/school productivity are not commonly used. Promoting the use of PROMs strategies, including optimizing consultation time and incorporating PROMs into electronic medical records, is necessary.
期刊介绍：
Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
