Implementing a Patient-Reported Outcome Measure for Hemodialysis Patients in Routine Clinical Care

作者：Jenna M. Evans, Alysha Glazer, Rebecca Lum, Esti Heale, Marnie MacKinnon, Peter G. Blake, Michael W. Walsh · 发表于：Clinical Journal of the American Society of Nephrology · 年份：2020 · DOI：10.2215/cjn.01840220 · 被引用次数：59 · 研究领域：Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes、Acute Kidney Injury Research

BACKGROUND AND OBJECTIVES: The Edmonton Symptom Assessment System Revised: Renal is a patient-reported outcome measure used to assess physical and psychosocial symptom burden in patients treated with maintenance dialysis. Studies of patient-reported outcome measures suggest the need for deeper understanding of how to optimize their implementation and use. This study examines patient and provider perspectives of the implementation process and the influence of the Edmonton Symptom Assessment System Revised: Renal on symptom management, patient-provider communication, and interdisciplinary communication. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Eight in-facility hemodialysis programs in Ontario, Canada, assessed patients using the Edmonton Symptom Assessment System Revised: Renal every 4-6 weeks for 1 year. Screening and completion rates were tracked, and pre- and postimplementation surveys and midimplementation interviews were conducted with patients and providers. A chart audit was conducted 12 months postimplementation. RESULTS: =319), respectively. Nine patients/caregivers from three sites and 48 providers from all sites participated in interviews. A total of 1207 charts were audited. Seven of eight sites had mean screening rates over 80%, suggesting that routine use of the Edmonton Symptom Assessment System Revised: Renal in clinical practice is feasible. However, the multiple data sources painted an inconsistent picture of the value and effect of the Edmonton Symptom...