Shanthini Kasturi, MD, MS: Patient-Reported Outcome Measures to Enhance SLE Treatment

Rheumatology Network interviewed Shanthini Kasturi, MD, MS, to discuss her recent study, “Clinical integration of patient-reported outcome measures to enhance the care of patients with SLE: a multi-center prospective cohort study.” She is an attending rheumatologist at Tufts Medical Center, Assistant Professor of Medicine at Tufts University School of Medicine, a Medical Advisor to CreakyJoints, and is affiliated with ArthritisPower.

When asked what sparked her interest in investigating the importance of patient-reported outcome measures (PROMs) in this patient population, Kasturi explained, “I've always had a clinical interest in lupus. It's very clear that quality of life and a lot of functional domains that are the focus of patient-reported outcome measures are a big deal in this population, particularly in quality-of-life areas like fatigue, pain, and cognition. These are the things that affect the day-to-day lives of people with lupus and, often, are not the focus of medical visits. PROMs are an [effective] way to highlight the perspective of patients and bring those topics to the center of attention.”

The prospective cohort study was implemented using data from 2 academic medical centers. Patients with lupus completed patient-reported outcome measure surveys before routine medical appointments. Investigators concentrated on domains that had been deemed important to other patients with lupus who had participated in previous studies. They also had the opportunity to discuss the surveys with their doctors. Patients were followed for 2 visits after enrollment. At the end of the study, interviews and focus groups comprised of both doctors and patients highlighted nuanced feedback on the process. The main goal was to understand if it was feasible to integrate PROMs as a part of clinical encounters and the impact they had on care.

Results showed that the majority of patients (85%) completed the survey, emphasizing feasibility. Further, these surveys did not appear to increase visit lengths.

“The most important finding was the qualitative one, which was that a majority of patients found that using these surveys as part of their clinical care can help them,” Kasturi concluded. “It helped them communicate, it helped them feel connected to their doctor, it helped them feel like there was a stronger therapeutic relationship, it gave them a chance to self-reflect, and it validated their experience.”