Capturing patient reported outcomes and quality of life in routine clinical practice: ready for prime time?

Abstract

Aim: Aim of the present study was to assess the feasibility of using internet-tablets to capture patient reported outcomes (PRO) questionnaire in a busy gastroenterology clinic, and determine predictors of questionnaire completion. PRO and quality of life instruments are extensively used to estimate the burden of disease and as end-points in clinical trials. However, their collection by paper can be costly, prone to human errors, and inefficient. We hypothesized that the majority of patients, irrespective of age, gender or ethnicity, will be able to complete PRO questionnaires on Internet tablets in a timely manner with good levels of satisfaction.

Methods: Internet-enabled tablets were used to collect PRO, and summative scores of quality of life provided to physicians. Predictors of completion were first assessed univariately and then by multivariate analysis using automated stepwise selection method on 1,000 bootstrap samples. Patient satisfaction was assessed using 5 item Likert-like scale.

Results: During the 12 week period, 1625 patient visits (mean age 49.8 ± 14.3 years, females 55.2% and Whites 82.5%) entered PRO data into tablets, of which 1396 (85.9%) visits had complete response. Average completion time of PRO questionnaire was less than 10 minutes (9.3 minutes ± 7.0). Majority of the patients found tablets easy to use (69.7%) and preferred it over paper-based questionnaires (70.8%). Multivariate analysis showed that subjects who were white Caucasians (odds ratio [OR] 1.9; P=0.004), had higher Cleveland Clinic Global Quality of Life (OR 2.2; P=0.027), or had either IBD or liver disease, were more likely to complete questionnaire (OR 4.0; P=0.001).

Conclusion: Collection of PROs in gastroenterology clinics using internet-tablets is feasible without any additional overhead, and with good levels of patient satisfaction and completion rates.