OBJECTIVES

: Clinical application of PROMs requires a good understanding of the factors affecting the health of patients with chronic conditions, and how they appraise their experience of their condition. The aim of the study is to explore the patient's narrative on time-dependent variation of PRO scores across different time-points for patients with multiple chronic conditions.

METHODS

: This is a mixed methods, longitudinal study interviewing 12 patients from GP practices up to 3 times in 9 months. Patients were eligible if they were 18 years and above, diagnosed with 2 or more of the following conditions: asthma, depression and/or osteoarthritis. A week prior to the qualitative interview patients were asked to complete paper or electronic generic and disease-specific PROMs including PROMIS-10, Patient Health Questionnaire (PHQ-9), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Asthma Quality of Life Questionnaire (AQLQ). Their PRO scores were calculated and the interviews focused on their scores, what factors influenced their scoring, and what external (socially determined) and internal (mood, cognitive function) factors impacted on how they reported their symptoms. Framework analysis was used to analyse the data.

RESULTS

: Preliminary results indicate that fluctuations of PRO scores occur, with pain/stiffness for osteoarthritis patients at its worst in the morning and evening, asthma symptoms and depressive symptoms worst in the morning. Appraisal of their conditions was influenced by both internal (e.g. low mood, fatigue, stress levels) and external (e.g. participation in daily activities, weather conditions) factors. Additional analyses are being conducted on the interviews with results to be presented at the conference.

CONCLUSIONS

: This is the first study exploring the patient narrative of variation of PROMs across time. The results will be considered in relation to the current theoretical understanding of health outcomes, providing evidence to support the potential implications of time-dependent variation in relation to planning healthcare delivery.