Variation and Change Over Time in PROMIS-29 Survey Results Among Primary Care Patients With Type 2 Diabetes

Authors

Juell Homco, University of Oklahoma-University of Tulsa School of Community MedicineFollow
Kristin Rodriguez, University of Oklahoma-University of Tulsa School of Community MedicineFollow
David R. Bardach, National Committee for Quality Assurance (NCQA)Follow
Elizabeth A. Hahn, Northwestern University Feinberg School of MedicineFollow
Suzanne Morton, National Committee for Quality Assurance (NCQA)Follow
Daren Anderson, Community Health Center, Inc.Follow
David Kendrick, University of Oklahoma-University of Tulsa School of Community MedicineFollow
Sarah Hudson Scholle, National Committee for Quality Assurance (NCQA)Follow

Publication Date

4-29-2019

Keywords

patient-reported outcomes, health-related quality of life, outcome measurement, health care planning, PROMIS

Abstract

Purpose: We sought to describe results of patient-reported outcome measures implemented among primary care patients with diabetes and explore factors associated with changes in scores over time.

Methods: Two organizations serving diverse patient populations collected the PROMIS-29 survey at baseline and 3-month follow-up for patients with type 2 diabetes. Bayesian regression analysis was used to examine the relationship between patient characteristics and changes in PROMIS-29 scores. Exploratory analyses assessed relationships between goal-setting and changes in scores.

Results: The study population reported substantially more problems with physical functioning (mean: 42.5 at Site 1 and 38.9 at Site 2) and pain interference (mean: 58.0 at Site 1 and 61.1 at Site 2) compared to the general population (mean: 50; standard deviation: 10). At least 33% of patients had a clinically meaningful change (ie, at least half the standard deviation, or 5 points) in each PROMIS domain. For pain interference, 55% had no change, 22% improved by 5 or more points, and 23% worsened by 5 or more points. Bayesian regression analyses suggest that chronic conditions, insurance status, and Hispanic ethnicity are likely associated with decreased functioning over time. Exploratory analyses found that setting a mental health goal did not appear to be associated with improvement for anxiety or depression.

Conclusions: Use of patient-reported outcome measures in routine clinical care identified areas of functional limitations among people with diabetes. However, changes in participants’ PROMIS-29 scores over time were minimal. Research is needed to understand patterns of change in global and domain-specific functioning, particularly among racial/ethnic minorities.

Recommended Citation

Homco J, Rodriguez K, Bardach DR, Hahn EA, Morton S, Anderson D, Kendrick D, Scholle SH. Variation and change over time in PROMIS-29 survey results among primary care patients with type 2 diabetes. J Patient Cent Res Rev. 2019;6:135-47. doi: 10.17294/2330-0698.1694