Why physicians underuse patient-reported outcomes in atopic dermatitis and chronic urticaria - Insights from the UCARE/ADCARE PROMUSE study.
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Cherrez-Ojeda Ivan, Robles-Velasco Karla, Giménez-Arnau Ana, Godse Kiran, Krasowska Dorota, Bartosińska Joanna, Szczepanik-Kułak Paulina, Wawrzycki Bartłomiej, Kolkhir Pavel, Allenova Anastasiia, Allenov Andrey, Tkachenko Sergey, Mitrevska Natasa Teovska, Mijakoski Dragan, Stoleski Sasho, Kolacinska-Flont Marta, Kuprys-Lipinska Izabela, Molinska Joanna, Kasperska-Zając Alicja, Zajac Magdalena, Zamlynski Mateusz, Mihaltan Florin, Ulmeanu Ruxandra, Zalewska-Janowska Anna, Tomaszewska Katarzyna, Al-Ahmad Mona, Al-Nesf Maryam Ali, Abhs MSs, Ibrahim Tayseer, Agel Sami, Pesqué David, Rodríguez-González Mónica, Wakida-Kuzunoki Guillermo Hideo, Ramon German D, Ramon Gonzalo N, Neisinger Sophia, Bonnekoh Hanna, Rukhadze Maia, Khoshkhui Maryam, Aliabadi Mehraneh Movahedi, Fomina Daria, Larenas-Linnemann Désirée, Košnik Mitja, Kara Rabia Oztas, Caballero López Chrystopherson Gengyny, Liu Qiang, Ivancevich Juan Carlos, Ensina Luis Felipe, Rosario Nelson, Kvedariene Violeta, Ben-Shoshan Moshe, Jardim Criado Roberta Fachini, Bauer Andrea, Cherrez Annia, Chong-Neto Herberto, Rojo-Guierrez Maria Isabel, Rudenko Michael, Larco Sousa José Ignacio, Lesiak Aleksandra, Matos Edgar, Muñoz Nelson, Moreno Jaime, Tinoco Ivan, Faytong-Haro Marco, Bousquet Jean, Zuberbier Torsten
Аннотация
METHODS: This is an observational, cross-sectional study where the PROMUSE questionnaire was used and applied to physicians from 45 specialized centers worldwide. Of the 2534 physicians surveyed in the PROMUSE study, 474 who treated patients with AD and CU were included in the analysis.
RESULTS: For the 474 physicians who treat AD and CU patients, the most common issues perceived as primary barriers to PROM use were "time constraints" (n = 455/474), "not mandated to complete" (n = 428/474), and "patients dislike PROMs" (n = 425/474). Higher rates of barrier perception were observed for males, younger physicians, and non-specialist physicians. The more barriers physicians perceive, the less frequently PROMs are used, with a strong and significant negative correlation between the number of barriers perceived and the frequency of PROM use. Two of the 15 perceived barriers significantly prevented using PROMs: the belief that PROMs constrain the doctor-patient relationship and the belief that patients dislike them.
CONCLUSIONS: The underutilization of PROMs in AD and CU is strongly driven by physicians' perceptions that patients dislike them and that they constrain the doctor-patient relationship. This suggests physicians may have deeper insights into the practical shortcomings of current instruments. Therefore, rather than solely focusing on physician education, existing AD and CU PROMs urgently require re-evaluation and co-development with direct patient involvement (eg, Core Outcome Sets) to ensure they are genuinely patient-centered and clinically relevant.