P069 The acceptability of ePROMs in the routine care of patients with inflammatory arthritis and its variation across patient groups: a mixed-methods study

Cox, Natasha; Kettle, Chelsea; Wang, Haboo; Dutta, Shouma; Packham, Jon; Galloway, James; Hill, Jonathan; Muller, Sara; Hider, Samantha; Paskins, Zoe; Bullock, Laurna; Scott, Ian

Abstract

Background/Aims Electronic patient-reported outcome measures (ePROMs) can facilitate innovative, holistic care for people with inflammatory arthritis (IA). The crucial first step in their implementation is understanding their feasibility and acceptability to patients and clinicians in routine care, and whether this varies across groups of patients (e.g. those with limited digital skills). This mixed-methods study, co-funded by the NIHR West Midlands Clinical Research Network (funding the quantitative survey) and BSR Research funding award (funding the qualitative interviews), aimed to address this. Methods Patients with IA attending rheumatology clinics at our Trust are invited to complete ePROMs on the Haywood Arthritis Portal (co-designed NHS platform with electronic health record integration). Patients attending clinics from January-2023 to April-2024 were invited to complete the Portal pre-appointment (on own device), with non-completers able to complete it in clinic (on NHS tablets). Surveys assessed ePROMs acceptability (generic Theoretical Framework of Acceptability questionnaire) (patients and clinicians) and eHealth literacy/digital skills (patients). Semi-structured interviews explored acceptability in purposively sampled participants. Data were analysed descriptively with Fisher’s exact tests comparing global acceptability by patient factors (e.g. e-health literacy). Interview analysis utilised the Rigorous and Accelerated Data Reduction technique. Results Patient Survey (n = 336): 89% found ePROMs “completely acceptable/acceptable” and 85% reported they required “little/no effort”. Whilst 89% felt they would benefit care, less (58%) agreed clinicians reviewed their ePROMs. Global acceptability had significant associations with e-health literacy (p<0.001) and digital skills (p<0.001), with more people with high (93%) vs. low (76%) e-health literacy rating them “completely acceptable/acceptable”, and more people (93%) with “foundation” digital skills (all 7 key skills required to independently access the internet) rating them “completely acceptable/acceptable” compared to 81% with “partial foundation skills” (≥1 key skill) and 43% that were “digitally excluded” (no key skills). HCP Survey (n = 11): 100% considered ePROMs “completely acceptable/acceptable” and 91% felt they required “little/no effort” to use. Patient Interviews (n = 11): supported quantitative findings. People considered ePROMs acceptable (e.g. “I think it’s a more appropriate way to gather that information and that it should save time in clinic, and I’m quite happy to do it”) and felt reassured that the Portal was NHS-developed. Clinician Interviews (n = 5): supported quantitative findings, with positive attitudes towards ePROMs (e.g. “I think it’s a good thing as part of my routine practice. I think it’s good that we’re recording certain details like the outcomes and things like that because we’ve got something to refer back to”. Participants had concerns around inclusivity (e.g., poor digital access/skills). Conclusion Using ePROMs in routine NHS IA care is highly acceptable to patients and clinicians. As acceptability is lower in patients with low eHealth literacy, and less digital skills, efforts are needed to support these groups in a digitally evolving NHS. Disclosure N. Cox: None. C. Kettle: None. H. Wang: None. S. Dutta: None. J. Packham: None. J. Galloway: None. J. Hill: None. S. Muller: None. S. Hider: None. Z. Paskins: None. L. Bullock: None. I. Scott: None.

Citation

Cox, N., Kettle, C., Wang, H., Dutta, S., Packham, J., Galloway, J., Hill, J., Muller, S., Hider, S., Paskins, Z., Bullock, L., & Scott, I. (2025, April). P069 The acceptability of ePROMs in the routine care of patients with inflammatory arthritis and its variation across patient groups: a mixed-methods study. Poster presented at British Society for Rheumatology Annual Conference 2025, Manchester Central Convention Complex, Manchester, England, UK

• Presentation Conference Type: Poster
• Conference Name: British Society for Rheumatology Annual Conference 2025
• Start Date: Apr 28, 2025
• End Date: Apr 30, 2025
• Acceptance Date: Apr 28, 2025
• Online Publication Date: Apr 28, 2025
• Publication Date: Apr 28, 2025
• Deposit Date: Jun 6, 2025
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Issue: Supplement_3
• DOI: https://doi.org/10.1093/rheumatology/keaf142.111
• Public URL: https://keele-repository.worktribe.com/output/1242633
• Publisher URL: https://academic.oup.com/rheumatology/article/64/Supplement_3/keaf142.111/8115071