The journal of vascular access · 2026
Implementation of electronic patient-reported outcome measures in hemodialysis: Findings from a matched cohort study.
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Barros João Pedro, Fonseca João Almeida, Pinto Rui, Pratas Jorge, Correia Ana Luísa, Pereira Alcides, Queirós Beatriz, Sousa Rui André, Lok Charmaine E, Correia Ricardo-Cruz
Аннотация
BACKGROUND: Integrating electronic patient-reported outcome measures (ePROMs) into routine hemodialysis (HD) care offers a way to enhance patient-centered decision-making.
METHODS: This prospective matched cohort study involved adults on in-center HD followed for 6 months. The intervention group completed monthly ePROMs (SF-VAQ and SF-36v2), while the control group received standard care. Outcomes included changes from baseline in Vascular Access (VA) related interventions, hospitalizations, SF-VAQ domain scores, and Health-Related Quality of Life (HRQoL).
RESULTS: Integrating ePROMs did not significantly impact the frequency of VA-related interventions or hospitalizations during the study period. Significant improvements were observed in the SF-VAQ domains, including reductions in perceived VA-related burden in the Physical (p = 0.002), Social (p = 0.001), and Dialysis-Related Complication (p = 0.001) domains. The Physical Component Summary (PCS) and Mental Component Summary (MCS) of the SF-36v2 also improved significantly (PCS: p = 0.001; MCS: p = 0.000). A total of 31 (55%) of patients in the ePROM group achieved the Minimal Clinically Important Difference.
CONCLUSIONS: Implementation of an ePROM-guided care pathway is feasible and associated with improved patient-reported well-being and reduced VA-related burden. While these results suggest a benefit, the absence of longitudinal process data in the control arm means further research is required to distinguish ePROM-induced changes from standard care evolution.
METHODS: This prospective matched cohort study involved adults on in-center HD followed for 6 months. The intervention group completed monthly ePROMs (SF-VAQ and SF-36v2), while the control group received standard care. Outcomes included changes from baseline in Vascular Access (VA) related interventions, hospitalizations, SF-VAQ domain scores, and Health-Related Quality of Life (HRQoL).
RESULTS: Integrating ePROMs did not significantly impact the frequency of VA-related interventions or hospitalizations during the study period. Significant improvements were observed in the SF-VAQ domains, including reductions in perceived VA-related burden in the Physical (p = 0.002), Social (p = 0.001), and Dialysis-Related Complication (p = 0.001) domains. The Physical Component Summary (PCS) and Mental Component Summary (MCS) of the SF-36v2 also improved significantly (PCS: p = 0.001; MCS: p = 0.000). A total of 31 (55%) of patients in the ePROM group achieved the Minimal Clinically Important Difference.
CONCLUSIONS: Implementation of an ePROM-guided care pathway is feasible and associated with improved patient-reported well-being and reduced VA-related burden. While these results suggest a benefit, the absence of longitudinal process data in the control arm means further research is required to distinguish ePROM-induced changes from standard care evolution.