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Determinants of Dropping Out of Remote Patient-Reported Outcome-Based Follow-Up Among Patients With Epilepsy:
Sofie Bech Vestergaard1,2, Mette Roost3, David Høyrup Christiansen2,4,5
1Department of Rheumatology, Aarhus University Hospital, Aarhus N, Denmark.
Background:
The use of patient-reported outcome (PRO) measures is an emerging field in health care. In the Central Denmark Region, epilepsy outpatients can participate in remote PRO-based follow-up by completing a questionnaire at home instead of attending a traditional outpatient appointment. This approach aims to encourage patient engagement and is used in approximately half of all epilepsy outpatient consultations. However, dropout in this type of follow-up is a challenging issue.
Objective:
This study aimed to examine the association between potential self-reported determinants and dropout in remote PRO-based follow-up for patients with epilepsy.
Methods:
This prospective cohort study (n=2282) explored the association between dropout in remote PRO-based follow-up for patients with epilepsy and 9 potential determinants covering 3 domains: health-related self-management, general and mental health status, and patient satisfaction. The associations were examined using multiple logistic regression analyses with adjustment for sex, age, education, and cohabitation.
Results:
A total of 770 patients (33.7%) dropped out of remote PRO-based follow-up over 5 years. Statistically significant associations were identified between all potential determinants and dropouts in PRO-based follow-up. Patients with low social support had an odds ratio of 2.20 (95% CI 1.38-3.50) for dropout. Patients with poor health ratings had an odds ratio of 2.17 (95% CI 1.65-2.85) for dropout. Similar estimates were identified for the remaining determinants in question.
Conclusions:
Patients with reduced self-management, poor health status, and low patient satisfaction had higher odds of dropout in remote PRO-based follow-up. However, further research is needed to determine the reasons for dropout.
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