Background Patient-reported outcome measures are an attractive option in medical practice, as the time burden is transferred from the clinician to the patient. Self administered questionnaires can be used to measure cross-sectional differences in the disease activity parameters reported by the patient at a point in time or longitudinal changes during a period of time. The approval of the International Classification of Functioning, Disability and Health (ICF), has led to an agreement on a definition of the ICF Core Set for AS.
Objectives To assess the validity, reliability, comprehensibility and sensitivity to change of the Arabic- Patient Reported Outcome Measures Questionnaire (PROMs) for use in standard clinical care of patients suffering from spondyloarthritis diseases.
Methods The PROMs questionnaire was developed on a two-pages sheet. One side includes 10 activities of daily living (translated CASQ-FI), 10 items to assess quality of life (translated CASQ-QoL), VAS for spinal pain, joint pain, global status, fatigue, duration of morning stiffness, review of the systems, falls and cardiovascular risks, self-helplessness as well as self-reported joint and soft tissue pain. The questionnaire was completed by 181 consecutive patients with AS (97) and spondyloarthritis (84). All patients were asked to complete the PROMs questionnaire while sitting in the waiting area before being examined by the treating physician. A supervising nurse was present to provide help, if needed. Constructs used for disease activity were BASDAI BASFI, BASG, the total enthesitis count, general well-being in the last week, spinal pain, joint pain, tender and swollen joint count, duration of morning stiffness and BASRI score. Disease activity was also assessed using the Ankylosing Spondylitis - Disease Activity Score (ASDAS). One week test retesting was performed to assess reliability of the questionnaire. Each patient was asked to rate the clarity of the questionnaires on a scale out of 10. Sensitivity to change of the PROMs questionnaire was assessed in 101 patients who completed the questionnaire before and 3 month after treatment. Changes in the questionnaire scores were compared to changes of other disease activity scores (BAS-FI, BAS-DAI, BAS-G and ASDAS).
Results The PROMs questionnaire was reliable as demonstrated by a high-standardized alpha. The questionnaire items correlated significantly (p<0.01) with clinical parameters of disease activity. Patient reported tender joints and enthesitis scores correlated significantly with the physician’s scores (correlation coefficient 0.867 and 0.883 respectively). Changes in functional disability, quality of life as well as self-helplessness scores showed significant (p<0.01) variation with diseases activity status. The PROMs questionnaire was completed in 8.4±1.2 minutes and showed a high degree of comprehensibility (9.4).
Conclusions The Arabic-PROMs questionnaire is a reliable and valid instrument for assessment of patients suffering from AS and spondyloarthritis. Being relatively short, rapid and comprehensive, this adds more to its applicability. The data support the value of completion of the simple 2 pages patient questionnaire, which provides a quantitative written documented record by the patient, at each visit to the rheumatologist.
Disclosure of Interest None Declared
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