Abstract
Kidney failure requiring dialysis is associated with high symptom burden and low health-related quality of life (HRQL). Patient-reported outcome measures (PROMs) are standardized instruments that capture patients’ symptom burden, level of functioning, and HRQL. The routine use of PROMs can be used to monitor aspects of patients’ health that may otherwise be overlooked, inform care planning, and facilitate the introduction of treatments. Incorporating PROMs into clinical practice is an appropriate strategy to engage patients and enhance their role in decisions regarding their care and outcomes. However, the implementation of PROMs measurement and associated interventions can be challenging given the nature of clinical practice in busy hemodialysis units, the variations in organization and clinical workflow across units, as well as regional programs. Implementing PROMs and linking these with actionable treatment aids to alleviate bothersome symptoms and improve patients’ wellbeing is key to improving patients’ health. Other considerations in implementing PROMs within a hemodialysis setting include integration into electronic medical records, purchase and configuration of electronic tools (i.e., tablets), storage and disinfection of such tools, and ongoing IT resources. It is important to train clinicians on the practical elements of using PROMs, however there is also a need to engage clinicians to use PROMs on an ongoing basis. This article describes how PROMs have been implemented at in-centre hemodialysis units in Alberta, Canada, addressing each of these elements.
Highlights
Patients with kidney failure requiring dialysis experience a high symptom burden and severity and low healthrelated quality of life (HRQL) [1]
Patients completed the modified Edmonton Symptom Assessment System (mESAS) monthly; results were recorded in Davison et al J Patient Rep Outcomes 2021, 5(Suppl 2):93 the electronic medical record (EMR), but not reviewed with the patient, nor tied to any specific guidance to inform clinical management
Alberta Kidney Care – South (AKC-S) had not implemented Patientreported outcome measures (PROMs) until recently, when Alberta Kidney Care – North (AKC-N) partnered with AKC-S and the Ontario Renal Network to design, pilot, and rigorously evaluate PROMs interventions for in-centre hemodialysis care
Summary
Patients with kidney failure requiring dialysis experience a high symptom burden and severity and low healthrelated quality of life (HRQL) [1]. Alberta Kidney Care – South (AKC-S) had not implemented PROMs until recently, when AKC-N partnered with AKC-S and the Ontario Renal Network to design, pilot, and rigorously evaluate PROMs interventions for in-centre hemodialysis care These interventions were designed based on successes from PROMs studies in oncologic settings[10, 11] intending to enhance communication between patients and clinicians, maximize patient participation in decision-making on reducing symptoms, improve HRQL, and facilitate self-management [12]. It was important to explore whether one single PROM is sufficient to improve patient-provider communication, processes of care, and patient outcomes, before recommending the use of a combination of generic and disease-specific measures. Disease‐specific PROMs The Edmonton Symptom Assessment System (ESAS) is a clinically validated and reliable symptom measurement tool, extensively used in chronic diseases including cancer, heart disease, and kidney disease [17] It was developed by the Regional Palliative Care Program, Capital Health in Edmonton, Alberta. The Integrated Palliative care Outcome Scale (IPOS) integrates questions from three different POS measures incorporating symptoms, information needs, practical concerns, family anxieties,
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
