01-03-2016 | Special Section: PROs in Non-Standard Settings (by invitation only) | Uitgave 3/2016 Open Access

AmbuFlex: tele-patient-reported outcomes (telePRO) as the basis for follow-up in chronic and malignant diseases
- Tijdschrift:
- Quality of Life Research > Uitgave 3/2016
Background
Improve quality of care by flagging important symptoms and produce better documentation of patient information
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Promote patient-centred care with focus on patients’ needs and knowledge about own disease
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Optimise the use of resources in the healthcare system
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Use PRO data in research and hospital quality assurance
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Methods
A. PRO data collection
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Questionnaire and pilot tests
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Referral
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Data collection modes
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B. PRO-based automated decision algorithm
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Thresholds defined by published cut-off values
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Thresholds defined by clinicians
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C. PRO-based graphical overview for clinical decision support
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Course-oriented graphic overview
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Configuration of PRO for clinical decision support
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PRO data collection
PRO-based automated decision algorithm
PRO-based graphical overview for clinical decision support
Results
Diagnostic group
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In operation from
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Mode
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Elements (cf. Table
2)
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PRO instruments
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Outpatient clinics
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Patients referred
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Patients referred pr. mo. (average the last 6 mo.)
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Reminders
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Initial response rate %
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Response rate follow-up %
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---|---|---|---|---|---|---|---|---|---|---|
a. Heart disease
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July 2011
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Paper/web
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A, B
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HADS
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n/a
|
4432
|
106
|
1
|
81
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No follow-up
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b. Epilepsy
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March 2012
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Paper/web
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A, B, C
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WHO-5, SF-36, SCL-92, ad hoc items
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3
|
4214
|
43
|
3
|
92
|
95
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c. Narcolepsy
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Sept. 2013
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Paper/web
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A, B, C
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WHO-5, SF-36, ESS, SCL-92, ad hoc items
|
2
|
70
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1
|
3
|
98
|
93
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d. Rheumatoid arthritis
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May 2014
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Paper/web
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A, B, C
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FLARE, HAQ
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2
|
300
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n/a
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0
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93
|
98
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e. Sleep apnoea
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July 2014
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Paper/web
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A, B, C
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ESS, SCL-92, ad hoc items
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2
|
2822
|
272
|
3
|
95
|
97
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f. Prostate cancer
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Sept. 2014
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Paper/web
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A, B, C
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EORTC QLQ-C30, DANPSS, IIEF-5, RT-ARD, WHO-5
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3
|
347
|
28
|
2
|
98
|
95
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g. Colorectal cancer
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March 2015
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Web
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A, B, C
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Ad hoc items
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1
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477
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60
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0
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n/a
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n/a
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h. Asthma
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April 2015
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Web/app
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A, B, C
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ACQ
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1
|
25
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2
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1
|
91
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n/a
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i. Renal failure
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Aug. 2015
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Paper/web
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A, B, C
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HADS, SCL-92, EQ-5D, BIPQ, ad hoc items
|
1
|
448
|
90
|
1
|
84
|
90
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PRO data collection
Questionnaire and pilot tests
Referral
Data collection modes
PRO-based automated decision algorithm
Thresholds defined by published cut-off values
Thresholds defined by clinicians
Diagnostic group
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Total PRO responses
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Green responses (%)
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Yellow responses (%)
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Red responses (%)
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No further contact to the clinic %
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Contact to the clinic
a %
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---|---|---|---|---|---|---|
Epilepsy
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8256
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1035 (12)
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5110 (62)
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2111 (26)
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48
|
52
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Sleep apnoea
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1424
|
202 (14)
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673 (47)
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549 (39)
|
57
|
43
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Prostate cancer
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347
|
38 (11)
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128 (37)
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181 (52)
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26
|
74
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Heart disease
b
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1335
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932 (69.8)
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0
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403 (30.2)
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n/a
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n/a
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PRO-based graphical overview for clinical decision support
Course-oriented graphic overview
Configuration of PRO for clinical decision support
Example: patient flow in outpatients with epilepsy
Feedback from clinicians and patients
Discussion
Repeated outpatient follow-up visits
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Fluctuation in disease activity
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PRO essential for clinical evaluation
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No need for physical examination
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