부산대학교 도서관

Introduction: Peripheral artery disease (PAD) is a chronic disease that requires continuous and individualized disease-management to optimize patients’ symptoms, function and quality of life. Directly capturing patient-reported outcomes (PROs) in routine practice has the potential to increase the patient-centeredness of PAD care. We designed and implemented a system to measure health status within the workflow of a vascular specialty clinic.Methods: In a large academic center, from February 2020 until March 2022, an in-person patient navigation system (Yale PRO-QI) supported by a online data collection workbench was implemented to collect the EQ-5D, Peripheral Artery Questionnaire (PAQ), and VascuQol-6 as part of the outpatient consultations for lower-extremity PAD. Completion rates by month, and domain and summary scores for each PRO were derived per clinical phenotype: new patient/pre-procedural patient, post-procedural/follow-up patient.Results: Of 1071 eligible patient visits, 841 PRO assessments (n=446 unique patients) were completed, for an overall completion rate of 78.5% (monthly completion range 56.4%-100.0%). Patients had a mean age of 70.5±10.2 years, 39.4% were female, 9.6% Hispanics, 14.6% blacks, and 74.7% whites. Of the PROs administered, only the Symptom Stability, Treatment Satisfaction, and Quality of Life subscales of the PAQ were able to discriminate between the clinical phenotypes with differences that reached the minimal clinically important difference threshold of ~10 points (Figure).Conclusions: In anticipation of measurement-based care metrics that assess quality of care benchmarks for patient-centered PAD care, our health system integrated PRO workflow had a high response rate, and was able to successfully discriminate between highly symptomatic vs. stable patients as measured by validated disease-specific PRO benchmarks for PAD treatment success.