Logo image
Back
Development of a Patient-centered Outcome Measure for Emergency Department Asthma Patients
Journal article   Open access   Peer reviewed

Development of a Patient-centered Outcome Measure for Emergency Department Asthma Patients

Margaret E. Samuels-Kalow, Karin V. Rhodes, Mira Henien, Emily Hardy, Thomas Moore, Felicia Wong, Carlos A. Camargo, Caroline T. Rizzo and Cynthia Mollen
Academic emergency medicine, v 24(5), pp 511-522
01 May 2017
DOI: https://doi.org/10.1111/acem.13165
PMID: 28146297
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1111/acem.13165View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Emergency Medicine Life Sciences & Biomedicine Science & Technology
Background: Measuring outcomes of emergency care is of key importance, but current metrics, such as 72-hour return visit rates, are subject to ascertainment bias, incentivize overtesting and overtreatment at initial visit, and do not reflect the full burden of disease and morbidity experienced at home following ED care. There is increasing emphasis on including patient-reported outcomes, but the existing patient-reported measures have limited applicability to emergency care. Objective: The objective was to identify concepts for inclusion in a patient-reported outcome measure for ED care and assess differences in potential concepts by health literacy. Methods: A three-phase qualitative study was completed using freelisting and semistructured interviewing for concept identification, member checking for concept ranking, and cognitive interviewing for question development. Participants were drawn from three tertiary care EDs. Parents of patients (pediatric) or patients (adult) with asthma completed a demographic survey and an assessment of health literacy. Phase 1 participants also completed a freelisting exercise and qualitative interview regarding the definition of success following ED discharge. Phase 2 participants completed a member checking survey based on concepts identified in Phase 1. Phase 3 was a pilot of trial questions based on the highest-ranked concepts from Phase 2. Results: Phase 1 enrolled 22 adult patients and 37 parents of pediatric patients. Phase 2 enrolled 41 adult patients and 200 parents. Phase 3 involved 15 parents. Across all demographic/literacy groups, Phase 1 participants reported return to usual activity and lack of asthma symptoms as the most important markers of success. In Phase 2, symptom improvement, medication use and access, and asthma knowledge were identified as the most important components of the definition of post-ED discharge success. Phase 3 resulted in five questions for the proposed measure. Conclusions: A stepwise qualitative process can identify, rank, and formulate questions based on patient-identified concepts for inclusion in a patient-reported outcome measure for ED discharge. The four key concepts identified for inclusion: symptom improvement, medication access, correct medication use, and asthma knowledge are not measured by existing quality metrics.

Metrics

13 Record Views
14 citations in Web of Science
15 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Emergency Medicine
Logo image