Liv Marit Valen Schougaard|Caroline Trillingsgaard Mejdahl|Jakob Christensen|Kirsten Lomborg|Helle Terkildsen Maindal|Annette de Thurah|Niels Henrik Hjøllund
Patient-initiated versus fixed-interval patient-reported outcome-based follow-up in outpatients with epilepsy: a pragmatic randomized controlled trial
Aarhus University|Aarhus University|Aarhus University Hospital|Aarhus University|Aarhus University|Aarhus University|Aarhus University Hospital
abstract background use patientreported outcome pro could potentially contribute reorganization health care system ambuflex pro system used remote patient monitoring questionnaires sent patients fixed intervals pro data used clinicians decide whether patients need clinical attention better selfmanagement costsaving followup activities may achieved letting patients initiate need contact evaluated effects patientinitiated probased outpatient followup health care resource utilization quality care patient perspective methods conducted parallel twoarm pragmatic randomized controlled trial department neurology aarhus university hospital denmark outpatients epilepsy 15 years old attending fixedinterval probased followup webbased questionnaires randomly assigned ratio 055045 either 1 patientinitiated probased followup open access telepro 2 fixedinterval probased followup standard telepro primary outcome number outpatient hospital contacts related epilepsy retrieved regional registry hospitals admissions emergency room visits also assessed secondary selfreported outcomes including general health wellbeing health literacy selfefficacy number seizures side effects confidence safety satisfaction retrieved questionnaires data analyzed intentiontotreat perprotocol approaches results january 2016 july 2016 593 patients randomized either open access telepro n 346 standard telepro n 247 18 months statistically significant differences found arms regarding number telephone consultations outpatient visits patients open access arm slightly lower statistically significant number emergency room visits patients standard arm selfreported mental wellbeing open access arm slightly statistically significantly lower standard arm secondary outcomes differ statistically significantly arms conclusion study find hypothesized less use health care resources improved patient selfmanagement satisfaction patientinitiated probased initiative compared fixedinterval probased followup patientinitiated probased followup may used alternative fixedinterval probased followup patients prefer approach insufficient evidence recommending systemwide shift patientinitiated probased followup trial registration registered 4 february 2016 clinicaltrialsgov nct02673580