A pilot trial of integrating the Patient-Reported Outcome Measurement Information System (PROMIS) into rheumatology care

Objective Utilising Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires can enhance clinical care by measuring longitudinal changes in symptom severity as reported by the patient. The aim of this pilot study was to assess the feasibility and impact of incorporating PROMIS questionnaires at the point-of-care in rheumatology practice. Methods Patients with rheumatic diseases and decrements in ≥1 PROMIS domain (pain intensity, physical function, or sleep disturbance) were stratified by their concerning domain, then randomised to either receive an interpretation of their PROMIS scores prior to their rheumatology appointment (Arm 1) or to usual care (Arm 2) (ClinicalTrials.gov ID: NCT05026853). The primary outcome was the documentation of PROMIS scores in the electronic medical record (EMR). Secondary outcomes include recommendations made by physicians based on PROMIS scores, patient-provider communication, and change in the most concerning PROMIS domain score from baseline to 12 weeks. Results 110 patients were enrolled. 55 were randomised to receive report cards (Arm 1), of which 46 received the report card, and 55 received usual care (Arm 2). Documentation of PROMIS scores in the EMR was 50% higher in Arm 1 (12.7% in Arm 2, p<0.0001). More recommendations were made based on PROMIS scores for Arm 1 patients. There was no significant difference in post-visit PROMIS score improvement between Arm 1 and Arm 2. Conclusion Providing PROMIS report cards to patients and healthcare providers increased score documentation in the EMR. Increased recommendations made based on PROMIS scores in Arm 1 suggest that having a score interpretation might help direct medical decision-making.