PROs in practice: starting the conversation

As the clinical trial efficacy of contemporary antiretroviral regimens consistently exceed 90%, the impact of therapy on an individual’s overall health, including sense of wellbeing, has become an important consideration for clinicians when prescribing HIV treatment.1

“Now that we have great HIV therapies, for instance, the difference between them may be how people experience those treatments,” said Professor David Wohl from the University of North Carolina, Chapel Hill, during a recent interview on the benefits of patient-reported outcomes (PROs) in clinical practice. “We should be thinking about the experience of the participant… not just thinking about the adverse events…,” he said.

“PROs open up a conversation that may not have been elicited if I simply asked: how are you doing today?”

– Professor David Wohl

 

According to Prof. Wohl, PROs are a different way of eliciting information from people living with HIV (PLHIV) – information that may otherwise be missed during a typical consultation.

PROs are generated from questionnaires that ask individuals to assess how interventions have, over time, affected their quality of life, daily functioning, symptom severity, and other dimensions of health, which only the individual can know.2 This strategy avoids the limitations of open-ended questions and/or answers while encouraging honest rather than ‘socially desirable’ responses.3

Prof. Wohl explained that, in the context of clinical practice, a clinician might decide that they need to know more about depression in his or her cohort of patients. To do that, they might introduce a validated PRO tool that specifically addresses issues associated with mental health and ask patients in the waiting room to complete the questionnaire. The clinician can then use the information provided to delve deeper into issues that have been highlighted as important to that individual.

“It’s maybe the start of a conversation, not the end of a conversation,” added Wohl. “PROs open up a conversation that may not have been elicited if I simply asked: how are you doing today?” he said.

View the interviews with Professor David Wohl

What are PROs

 

How PROs can tell you more about your patient’s response to HIV therapy 

 

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