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Patient Perspective in the Development of Electronic Patient-Reported Outcomes (ePROs) in Seizure Disorders: A Patient-Centric Approach

Authors Khan A, Peechatka A, Dias NR, Lima V, Seddo M, Inja A, Dallabrida SM

Received 18 July 2019

Accepted for publication 7 December 2019

Published 6 January 2020 Volume 2020:14 Pages 13—21


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Anzalee Khan,1,2 Alyssa Peechatka,3 Nadeeka R Dias,3 Viviane Lima,3 Mary Seddo,2 Ayla Inja,2 Susan M Dallabrida4

1Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; 2Manhattan Psychiatric Center, New York, NY, USA; 3eResearch Technology Inc., Boston, MA, USA; 4Oracle, Burlington, MA, USA

Correspondence: Anzalee Khan
Nathan S. Kline Institute for Psychiatric Research, c/o Manhattan Psychiatric Center, 1 Wards Island Complex, Wards Island, NY 10035, USA
Tel +1 646 672 6005
Fax +1 646 672 6276

Background: Patient-centered outcomes research (PCOR) emphasizes the patient perspective and input to inform the research process with the aim to improve the quality of care. Given PCOR’s emphasis on the patient perspective, methods to incorporate patient-reported outcomes (PROs) are important. Electronic PROs (ePROs) have been implemented successfully in many populations; however, many of these measurements do not incorporate patient perspective in the development of ePROs. For epilepsy and seizure disorders, user perspectives are key to developing measurements that capture real-time data, as seizures are not timed events; therefore, patients can wait days or even weeks and then try to recall their experience which can lead to variations in recall. ePRO can provide the necessary assurance that data were entered by the patient at the time the episode occurs. The aim of the present study was to assess patient perceptions of completing ePROs, expectations of ePRO devices for PCOR and on-site clinical visit in order to guide the development of successful ePRO deployment in seizure-related disorders.
Methods: This study used a naturalistic cohort design. A sample of 713 persons completed an online survey which consisted of 11 situational questions. Of the 713 individuals, results from 640 participants were included. Results were compared using a Wilcoxon signed-rank test.
Results: Most participants (71.9%) were able to accurately identify a seizure and 86.3% of participants felt it would be beneficial to have a short training on seizure symptoms prior to completing a daily seizure diary, and seizures should be reasonably reported within 10 mins (n = 426, 66.6%). Participants endorsed that repetitive movements and loss of consciousness as the most predominant symptoms they would look for in an ePRO. A majority of participants, 67.0% indicated that they regularly use accessibility features on using smartphones and tablets, and 38.6% indicated they would like to see more than one item per screen but only if they are related and to see all text in a larger size with scrolling features using fingers (n = 246; 38.4%).
Conclusion: This study has demonstrated the importance of developing ePROs that satisfy the needs of the participants and caregivers without compromising the scientific and clinical aspects of the disease construct. Developing tools using participant needs, observations, characteristics and input is essential to putting the participant perspective in patient-centered outcomes research.

Keywords: epilepsy, technology assisted counseling, TAC, patient perception, electronic outcomes

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