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W 38: Patient Preference for Electronic Patient Reported Outcomes: Assessment in Patients with Psoriatic Arthritis (PsA)
Celeste A. Elash
To provide evidence of patient acceptance and preference for electronic PROs in patients with PsA, this poster will describe results of acceptance and preference surveys collected in the context of a randomized, crossover paper (P) – electronic tablet (E) mode equivalence study.
To establish equivalence of P and E versions of 7 PROs in PsA patients, a randomized, crossover equivalence study was conducted. After patients (N=53) completed the P and E versions of each PRO, they completed a survey on ease of use, acceptability and preference for the P and E versions.
Equivalence of Paper and Electronic PROs: Intraclass Correlation Coefficients ranged from 0.75 to 0.97, all above the generally accepted threshold of .70. T-tests revealed no significant mean difference between P and E scores, and mean score differences between P and E measures were small and within an acceptable limit of equivalence.
Patient ease of use, acceptability and preference for Paper and Electronic PROs: Patient ratings of acceptability were high for both tablet (52; 98.1%) and paper (50; 96.2%) and few patients reported problems using the tablet (2; 3.8%) or paper (4; 7.6%). Patient quotes suggest some problems may have been directly related to patients’ PsA. Although they did not report difficulty using the stylus to respond to questions on the tablet, patients did express concerns about holding a pen to complete the paper: “My handwriting is not as good and my hand was getting tired due to the arthritis and little painful and stiff”; “Holding a pen becomes difficult over time”; “Discomfort in hands at times with pen.” Patients reported additional difficulties related to vision for both the tablet and paper versions. In reference to the tablet, two patients reported having to move the tablet to avoid glare from overhead lighting. With regard to paper, one patient noted: “ I have trouble reading paper for a long time.”
Despite similarities in ratings of acceptability for the tablet and paper, the majority of patients (45; 84.9%) reported that the electronic tablet was ‘very easy’ to use, while fewer than half (23; 44.2%) reported the same rating for paper (p<.001). The majority of patients (37; 74%) preferred the tablet to paper, while 12 (24%) had no preference, and only 1 (2%) preferred paper. Patient quotes reflect the general acceptance of the tablet, and the preference for it over paper: “I think everyone should use one; it's very easy to use.”; “It's easier, faster, comfortable.”; “Much easier than the paper to use.”
Although results indicate that the PRO scores are equivalent when administered to patients with PsA via electronic and paper modes, tablet versions may be a more viable option for use in clinical trials with PsA patients. Patient reports of specific problems holding a pen or writing for long periods of time suggest that electronic tablets may reduce the burden of data collection on PsA patients in clinical trials, and patients rated the tablet version to be easier to use, and reported a clear preference for it over paper. These results support the use of the electronic tablet versions of PRO measures in PsA clinical trials.