Dataset Information

Incorporating PROMIS Symptom Measures into Primary Care Practice-a Randomized Clinical Trial.

ABSTRACT:

Background

Symptoms account for more than 400 million clinic visits annually in the USA. The SPADE symptoms (sleep, pain, anxiety, depression, and low energy/fatigue) are particularly prevalent and undertreated.

Objective

To assess the effectiveness of providing PROMIS (Patient-Reported Outcome Measure Information System) symptom scores to clinicians on symptom outcomes.

Design

Randomized clinical trial conducted from March 2015 through May 2016 in general internal medicine and family practice clinics in an academic healthcare system.

Participants

Primary care patients who screened positive for at least one SPADE symptom.

Interventions

After completing the PROMIS symptom measures electronically immediately prior to their visit, the 300 study participants were randomized to a feedback group in which their clinician received a visual display of symptom scores or a control group in which scores were not provided to clinicians.

Main measures

The primary outcome was the 3-month change in composite SPADE score. Secondary outcomes were individual symptom scores, symptom documentation in the clinic note, symptom-specific clinician actions, and patient satisfaction.

Key results

Most patients (84%) had multiple clinically significant (T-score ≥ 55) SPADE symptoms. Both groups demonstrated moderate symptom improvement with a non-significant trend favoring the feedback compared to control group (between-group difference in composite T-score improvement, 1.1; P = 0.17). Symptoms present at baseline resolved at 3-month follow-up only one third of the time, and patients frequently still desired treatment. Except for pain, clinically significant symptoms were documented less than half the time. Neither symptom documentation, symptom-specific clinician actions, nor patient satisfaction differed between treatment arms. Predictors of greater symptom improvement included female sex, black race, fewer medical conditions, and receiving care in a family medicine clinic.

Conclusions

Simple feedback of symptom scores to primary care clinicians in the absence of additional systems support or incentives is not superior to usual care in improving symptom outcomes.

Trial registration

clinicaltrials.gov identifier: NCT02383862.

SUBMITTER: Kroenke K

PROVIDER: S-EPMC6082211 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Incorporating PROMIS Symptom Measures into Primary Care Practice-a Randomized Clinical Trial.

Kroenke Kurt K Talib Tasneem L TL Stump Timothy E TE Kean Jacob J Haggstrom David A DA DeChant Paige P Lake Kittie R KR Stout Madison M Monahan Patrick O PO

Journal of general internal medicine 20180405 8

<h4>Background</h4>Symptoms account for more than 400 million clinic visits annually in the USA. The SPADE symptoms (sleep, pain, anxiety, depression, and low energy/fatigue) are particularly prevalent and undertreated.<h4>Objective</h4>To assess the effectiveness of providing PROMIS (Patient-Reported Outcome Measure Information System) symptom scores to clinicians on symptom outcomes.<h4>Design</h4>Randomized clinical trial conducted from March 2015 through May 2016 in general internal medicine ...[more]

PMID: 29623512

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Dataset Information

Incorporating PROMIS Symptom Measures into Primary Care Practice-a Randomized Clinical Trial.

Background

Objective

Design

Participants

Interventions

Main measures

Key results

Conclusions

Trial registration

Publications

Incorporating PROMIS Symptom Measures into Primary Care Practice-a Randomized Clinical Trial.

Similar Datasets

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