Using Patient-Reported Outcome Measures to Evaluate Care for Patients With Inflammatory Chronic Rheumatic Disease

Daniela Rodrigues; Andrew Street; Maria José Santos; Ana Maria Rodrigues; João Marques-Gomes; Helena Canhão

doi:10.1016/j.jval.2022.05.012

Using Patient-Reported Outcome Measures to Evaluate Care for Patients With Inflammatory Chronic Rheumatic Disease

Value Health. 2022 Jun 23:S1098-3015(22)02000-9. doi: 10.1016/j.jval.2022.05.012. Online ahead of print.

Authors

Daniela Rodrigues¹, Andrew Street², Maria José Santos³, Ana Maria Rodrigues⁴, João Marques-Gomes⁵, Helena Canhão⁴

Affiliations

¹ NIHR Imperial Patient Safety Translational Research Center, Institute of Global Health Innovation, Department of Surgery & Cancer, Imperial College London, London, England, UK. Electronic address: d.rodrigues@imperial.ac.uk.
² Department of Health Policy, London School of Economics and Political Science, London, England, UK.
³ Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal; JE Fonseca Lab, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
⁴ EpiDoC Unit, NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal; CHRC, Comprehensive Health Research Center, NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal; Rheumatology Unit, University Central Hospital Lisbon (CHULC), Lisboa, Portugal; ReumaPt, Sociedade Portuguesa de Reumatologia, Lisboa, Portugal.
⁵ Nova School of Business and Economics, Carcavelos, Portugal; NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal.

PMID: 35753905
DOI: 10.1016/j.jval.2022.05.012

Abstract

Objectives: Few countries integrate patient-reported outcome measures (PROMs) in routine performance assessment and those that do focus on elective surgery. This study addresses the challenges of using PROMs to evaluate care in chronic conditions. We set out a modeling strategy to assess the extent to which changes over time in self-reported health status by patients with inflammatory chronic rheumatic disease are related to their biological drug therapy and rheumatology center primarily responsible for their care.

Methods: Using data from the Portuguese Register of Rheumatic Diseases, we assess health status using the Health Assessment Questionnaire-Disability Index for rheumatic patients receiving biological drugs between 2000 and 2017. We specify a fixed-effects model using the least squares dummy variables estimator.

Results: Patients receiving infliximab or rituximab report lower health status than those on etanercept (the most common therapy) and patients in 4 of the 26 rheumatology centers report higher health status than those at other centers.

Conclusions: PROMs can be used for those with chronic conditions to provide the patient's perspective about the impact on their health status of the choice of drug therapy and care provider. Care for chronic patients might be improved if healthcare organizations monitor PROMs and engage in performance assessment initiatives on a routine basis.

Keywords: comparative effectiveness of treatments; patient-reported outcome measures; performance of healthcare organizations; rheumatology.