Patient reported outcomes (PROs) are any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a health professional or anyone else. Originally, PROs were introduced to assess patient quality of life but have subsequently been developed to assess many facets of patient status.
There is robust evidence that this type of measure reliably distinguishes placebo from control treatment in clinical trials. Furthermore, patient self-assessment of physical function predicts severe outcomes in rheumatoid arthritis such as work disability and premature mortality at higher levels of significance than laboratory tests or imaging studies. Self-report of physical function is significant in prognosis of mortality in many diseases and in the general elderly population. PROs can provide treatment targets in inflammatory arthritis either alone or as part of composite measures. Yet their place in routine patient assessment and their utility for guiding clinical care is often questioned by busy clinicians.
The dilemmas of which assessment tool in which patient at what frequency and by which administration method, present further barriers to implementation even when their utility is accepted. Data and insights derived from implementation of routine PRO assessment over 4 years will be presented in the context of a rapidly increasing international focus on the value of PROs in optimising clinical care.