243PROMs in Practice
PROMs can be used to screen for health problems in clinical practice, which can go
undetected if patient participation is not involved. PROMs can be used to monitor
progress of chronic disease phase and its impact over time helps the clinician to
judge if the treatment is effective and modify the treatment when necessary. PROM
data can also be used to compare the quality of care in the clinical practice as well,
as clinicians can compare the outcomes to the benchmarks [ 62 ]. It remains to be
seen whether regular use of PROM assessment in daily practice may improve
patient–physician communication and may lead to better treatment adherence, by
allowing choice of common goals during a clinic visit.
Summary and Conclusions
PROMs for gout have been tested for validity, reliability, and responsiveness to
change in RCTs and observational studies and have been endorsed by
OMERACT. VAS or SF-36 pain can be used as a measure of pain in patients with
gout. HRQOL/function in patients with gout can be effectively measured by instru-
ments such as HAQ-DI and/or SF-36. These PROMs are a useful source of informa-
tion in addition to the physician-reported measures.
PROMs provide the patient’s perspective regarding the disease and can provide
important clues to managing a chronic disease, such as gout. PROMs are now rec-
ognized as important tools in understanding the impact of gout on patient lives and
could assist in more patient-centered care for the management of patients with gout.
However, at present PROMs are not widely integrated into clinical practice.
Therefore, assessment of PROMs and regular monitoring should be an integral
part of modern day clinical practice of clinicians caring for patients with gout.
Given the disparities observed between PROMs and physician- reported measures
and the association of PROMs with higher patient satisfaction, we suggest that phy-
sicians should use PROMs to evaluate benefi ts/harms of therapies in gout and their
acceptability to patients, and compliment this information with physician-assessed
measures, such as serum uric acid and radiographic changes.
Future Directions and Identifi cation of Gaps
As a chronic condition, gout requires frequent outpatient clinic visits, until allopu-
rinol or other medications become effective. A change in PROMs over time may be
due to effect of interventions or natural course of disease or measurement error.
Further research is required to establish the ideal time point/s to administer the
PROMs in primary care [ 63 ]. The relationship between PROMs and the quality of
delivered care is also of interest for future studies [ 63 ].
9 PROMs for Gouty Arthritis