Prioritizing patient-reported outcome measures for routine collection in rheumatoid arthritis: An integrated consensus-building process with patients and health care providers

Background: Effective clinical use of patient-reported outcome measures (PROMs) hinges on selecting appropriate measures.The aim of this study was to establish priorities for PROM routine collection in RA care at a health-system level based on patient and provider preferences.Methods: Candidate PROMs were identified through an environmental scan.We adopted a dual-panel consensus-building approach with a patient-exclusive panel, and separate engagement with rheumatology healthcare providers (HCPs).Consensus among patients with RA was established via a modified Delphi process, co-led with two patient partners.HCPs were engaged in a rating and discussion exercise with two groups of providers from academic centres.Patient-panel consensus was achieved if median ratings on a 9-point Likert scale were 7 in all 3 criteria (importance, content validity and feasibility) and results informed HCP discussions for final selection.Results: 15 patients with RA participated in the Delphi rounds and 22 HCPs participated in a rating exercise followed by two group discussions attended by a total of 43 rheumatologists.From an initial set of 15 candidate PROMs, 9 were rated highly ( 7) across all three criteria in Round 3 by patients.Among these, the PROMIS Physical Function 10a ranked highest.HCP feedback suggests a preference for PROMs that align with clinical documentation needs, including insurance forms for advanced therapies and disability claims. Conclusion:A measure of physical function achieved a high priority from the patient panel, and it also supports clinical documentation needs of HCPs, and will thus be an initial implementation focus. Keywords. rheumatoid arthritis patient-reported outcome measure Quality of CareOver the past half century, patient-reported outcome measures (PROMs) have been widely and effectively used alongside clinical, imaging, and laboratory assessments to evaluate and manage health outcomes in individuals living with rheumatoid arthritis (RA). [1][2]2][3][4] Their integration into clinical care has supported a patient-centered approach and enhanced communication between patients and providers. 5,6These benefits extend to clinicians and health systems by enabling consistent disease monitoring over time 5 and supporting quality improvement initiatives 7,8 that identify unmet needs at the systems-level to better inform policy and resource allocation decisions.Despite their proven value, the widespread implementation of PROMs in RA care is hindered by a lack of consensus on which specific measures are best suited for routine use.This uncertainty may reflect variation in patients, providers, and health systems valuing different aspects of care that best serve both RA patient needs and clinical workflows.In the context of increasing interest in value-based care and the development of learning health systems, 9,10 identifying consensus on PROMs that meet both clinical and patient needs is an important step toward