Abstract
BackgroundPatient-reported outcomes measures in clinical trials ensure that evaluations of effectiveness focus on outcomes that are important to patients. In relapsing-remitting conditions, such as eczema, repeated measurements may allow a more accurate reflection of disease burden and treatment effect than less frequent measurements.We asked parents/carers of children with eczema taking part in a trial of bath emollients to complete weekly questionnaires for 16 weeks.MethodsThe objective of this study was to determine the acceptability and practicality of collecting weekly measures of eczema severity online for 16 weeks in children aged 1 to 11 years as part of the BATHE study.BATHE randomised patients to bath emollients plus standard eczema care or standard eczema care only. The primary outcome was eczema severity, measured by the seven-item Patient-Oriented Eczema Measure (POEM) repeated weekly for 16 weeks. Acceptability was explored through qualitative interviews with 10 participants. Interviews were audio-recorded, transcribed and analysed thematically. Practicality was assessed by exploring the completeness of the data and keeping a log of any problems.ResultsFour hundred and eighty-two participants were recruited to the trial and 429 opted to complete measures online (89.0%). Data were collected online for 83% of time points over the 16-week period and there was no association between socio-demographic characteristics and data completeness. Two hundred and six (48%) completed their weekly data every week for 16 weeks and 341 (79%) completed it at least 80% of the time. The mean number of weeks completed was 13.3 out of 16 (SD 4.2).Interviewees said that they understood the rationale behind weekly collection and some welcomed this as it helped them realise how their child’s eczema changed weekly. Whilst some interviewees spoke of weekly questionnaires as onerous, others said that they found them quick and easy. Reminders were welcomed.Parents/carers seemed happy to receive telephone reminders and it was sometimes useful for eliciting problems relating to obtaining trial medication or password problems for online data collection.ConclusionsAmongst this population, high levels of data completeness suggests that weekly completion of the online questionnaire appears to be acceptable and feasible over a 16-week period.Trial registrationISRCTN84102309. Registered on 9 December 2013.
Highlights
Patient-reported outcomes measures in clinical trials ensure that evaluations of effectiveness focus on outcomes that are important to patients
In order for interventions to improve the quality of life in a way that is relevant to children and parents, it is important that the outcome measures used in studies capture their experiences of eczema and any perceived benefits of treatments Patient-reported outcome measures (PROMS) are reported directly by participants and are being used increasingly as primary outcomes in clinical trials in order to assess the overall patient experience or perception of benefit to participants [4]
Patient Orientated Eczema Measure (POEM) is recommended by NICE [17] and the international HOME initiative (Harmonising Outcome Measures in Eczema) and is the only patient-reported outcome that demonstrated sufficient validity and repeatability in a systematic review of outcome measures for eczema [18, 19]
Summary
Patient-reported outcomes measures in clinical trials ensure that evaluations of effectiveness focus on outcomes that are important to patients. In relapsing-remitting conditions, such as eczema, repeated measurements may allow a more accurate reflection of disease burden and treatment effect than less frequent measurements. Repeated measures are frequently used in clinical trials, rather than a single endpoint, in order to allow researchers to explore how treatment or the trajectory of a condition changes over time [1]. In order for interventions to improve the quality of life in a way that is relevant to children and parents, it is important that the outcome measures used in studies capture their experiences of eczema and any perceived benefits of treatments Patient-reported outcome measures (PROMS) are reported directly by participants and are being used increasingly as primary outcomes in clinical trials in order to assess the overall patient experience or perception of benefit to participants [4]. Gathering information regularly over time is essential for understanding disease burden [5], and to accurately assess the impact of interventions
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