OA39 Online Patient Reported Outcome Measure (PROM) engagement is dependent on demographics and locality: findings from an observational cohort

Abstract

Abstract Background/Aims Online patient-reported outcome measures (PROMs) enable remote collection of perceptions of health status, function and wellbeing. Single-centre studies report that PROM completion is dependent on patient demographics. Here we use a large national prospective dataset to explore patterns of PROM completion. Methods Patients with a new diagnosis of early inflammatory arthritis (EIA) were recruited to the National Early Inflammatory Arthritis Audit (NEIAA) between May 2018 and March 2020 and followed up for one year. PROMs capturing the impact of disease using the MSK-HQ, disability using HAQ, mental health using PHQ4ADS, and work using the WPAI were requested at baseline, 3 and 12 months. Multivariable logistic regression was constructed to examine patient level associations with PROM completion. Mean PROM completion by clinical commissioning groups (CCG) were mapped across England and spatial regression models used to identify regional patterns. Results A total of 34,856 patients with suspected EIA were recruited to NEIAA. Of these, 11,986 were diagnosed with EIA across England, recruited from 205 CCGs. The cohort was evenly distributed across the indices of multiple deprivation (IMD) deciles. Thirteen percent were Black, Asian, or minority ethnic (BAME). At least one PROM was completed by 5,331 (44.5%) patients. Of these, 3,846 (72.1%) had completed half of all the available PROMs whilst 412 (7.7%) had completed all available PROMs. BAME participants were less likely to return a PROM in adjusted regression modelling (adj OR 0.57, 95% CI 0.48-0.66). Deprivation quintile (adj OR 0.73, 95% CI 0.64-0.83), male gender (adj OR 0.86, 95% CI 0.78-0.94), comorbidity burden (adj OR 0.95, 95% CI 0.91-0.99) and current smoker status (adj OR 0.73, 95% CI 0.64-0.82) also reduced the odds of PROM completion. The proportion with PROM completion varied across CCGs. Spatial analysis identified two autocorrelated regions in England with a hotspot of high PROM completion in the North and a cold spot in the South East. Conclusion This study defines key participant characteristics that influence PROM engagement in a national clinical audit and identifies a novel association between locality and PROM completion. Integral to the utility of PROMs in NEIAA is that they are representative of the population with EIA. Our results suggest there are under-represented groups with the potential to bias in favour of those likely to experience better outcome. Disclosure K. Bechman: None. M. Yates: None. H. Wright: None. M. Russell: None. D. Nagra: None. B.D. Clarke: None. J. Ledingham: None. S. Norton: None. J. Galloway: Consultancies; Abbvie, Sanofi, Novartis, Pfizer, UCB, Janssen. Grants/research support; Eli Lilly.