Rapid Electronic Capturing of Patient-Reported Outcome Measures in Older Adults With End-Stage Renal Disease: A Feasibility Study

Jennifer Gabbard, Christopher J. McLouth, Gretchen Brenes, Sophie Claudel, Samantha Ongchuan, John Burkart, Nicholas Pajewski, Kathryn E. Callahan, Jeff D. Williamson, Mariana Murea

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background: Patients with end-stage renal disease (ESRD) have a high burden of physical and psychological symptoms. Many remain unrecognized for long periods of time, particularly in older adults. The best strategy to monitor patient-reported outcome measures (PROMs) has not been identified. Objective: To assess the feasibility of implementing an iPad-based symptom assessment tool in older adults with ESRD on hemodialysis (HD). Methods: We designed an iPad application-delivery system for collecting electronic PROMs (ePROMs). Patient’s ≥60 years of age with ESRD on HD were recruited from a single outpatient dialysis unit. Feasibility was evaluated based on recruitment, retention, and the system usability score (SUS). Assessments were completed at baseline, 3 months, and 6 months after enrollment. ANOVA was used to assess longitudinal symptom variability. Results: Twenty-two patients (49% recruitment rate) were enrolled, with an 82% retention at 6 months. Mean age was 69.4 years (SD 6.6), 63.6% were female, and 81.8% were African American. Participants reported minimal difficulty in using the app, with an overall SUS score of 77.6. There were no significant relationships between demographic characteristics (age, race, or education) and SUS. Baseline SF-12 physical score and SF-12 mental score were 40.4 (SD 9.1) and 33.9 (SD 6.7), respectively. No significant changes were seen in longitudinal ePROMs of pain, depression, or anxiety; but was seen in the dialysis symptom index. Conclusion: In older patients with ESRD, collection of iPad-based ePROMs is feasible. This process can overcome inefficiencies associated with paper questionnaires and enable systematic monitoring of symptom burden.

Original languageEnglish
Pages (from-to)432-440
Number of pages9
JournalAmerican Journal of Hospice and Palliative Medicine
Volume38
Issue number5
DOIs
StatePublished - May 2021

Bibliographical note

Publisher Copyright:
© The Author(s) 2020.

Keywords

  • clinical decision support system
  • mobile application
  • older adults
  • palliative medicine
  • patient reported outcome measures
  • renal dialysis
  • symptom burden

ASJC Scopus subject areas

  • General Medicine

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