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Responsiveness and clinical utility of PROMIS instruments in pediatric Crohn's disease: insights from a longitudinal

Sara Azevedo1,2, Maria Miguel Oliveira3,4, Paulo Nogueira3,4,5

  • 1Gastroenterology Unit, Pediatrics Department, Santa Maria University Hospital-CHLN, Academic Medical Centre of Lisbon, Lisbon, Portugal.

Frontiers in Pediatrics
|January 30, 2025
PubMed

Insights

Patient-Reported Outcomes Measurement Information System (PROMIS) instruments effectively track health improvements in pediatric Crohn's disease (CD) patients. These tools offer valuable insights for managing pediatric inflammatory bowel disease (IBD).

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Outcomes Research
  • Patient-Reported Outcomes

Background:

  • Inflammatory bowel disease (IBD) significantly impacts pediatric patients' physical, psychological, and social well-being.
  • Integrating patient-reported outcomes (PROs) is essential for comprehensive IBD management.
  • Standard clinical assessments may not fully capture the patient experience in pediatric IBD.

Purpose of the Study:

  • To assess the responsiveness and clinical utility of Patient-Reported Outcomes Measurement Information System (PROMIS) instruments.
  • To compare PROMIS instruments with standard clinical assessment tools in pediatric Crohn's disease (CD) patients.
  • To evaluate PROMIS's ability to detect changes in health status over time in pediatric CD.

Main Methods:

  • A prospective, longitudinal study involving 31 pediatric CD patients (aged 8-17).
  • Data collection occurred at baseline and every 6 months over 18 months.
  • PROMIS pediatric measures, pediatric Crohn's disease activity index (PCDAI), clinical markers, and IMPACT-III were used; analyzed with linear mixed-effects models.

Main Results:

  • PROMIS Global Health scores significantly improved, indicating enhanced overall health perception.
  • Significant reductions in PROMIS Pain Interference and Fatigue scores were observed, reflecting improved physical health.
  • PROMIS depression scores decreased, suggesting better mental health; these changes correlated with PCDAI and clinical markers.

Conclusions:

  • PROMIS instruments are clinically valuable for managing pediatric CD, offering insights into global health and quality of life.
  • The study confirmed PROMIS measures' responsiveness to disease activity changes in pediatric CD.
  • Routine integration of PROMIS into clinical practice can enhance management and treatment strategies for pediatric IBD.
Abstract

Keywords:
PROMIShealth-related quality of lifeinflammatory bowel diseaselongitudinal studypatient-reported outcome measurespediatric Crohn's disease

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