EULAR points to consider for including the perspective of young patients with inflammatory arthritis into patient-reported outcomes measures

EULAR points to consider for including the perspective of young patients with inflammatory arthritis into patient-reported outcomes measures

A range of patient-reported outcome measures (PROMs) with different features is available for people with inflammatory arthritis (IA). [1][2][3][4][5] However, the needs and priorities of young people (aged 18-35 years) with IA regarding PROMs and their administration have never been systematically explored. Therefore, our project tackled the question whether PROMs commonly used in IA cover the perspectives and needs of young people. For this purpose, a task force (TF) guided by the 2014 EULAR Standardised Operating Procedures was convened. 6 Given the limited literature on the perspectives of young people with IA regarding PROMs, a multinational focus group study 7 and a subsequent online survey distributed across Europe 8 replaced the conventional systematic literature review (online supplemental figure S1). The EULAR Council approved this research-based project approach. The TF was composed of 14 members from 8 European countries, with a strong representation of patient research partners. The TF met twice and, based on the results of the focus groups and survey, formulated four overarching principles (OPs), 8 points to consider (PtC) (table 1) and a research agenda (online supplemental table S1). Every TF member indicated agreement with a PtC or OP by formal voting (yes/no/ abstain) during the second meeting and then anonymously scored their level of agreement (Numerical Rating Scale ranging from 0='no agreement' to 10='absolute agreement') after the meeting in a subsequent email round. 6 OPs and PtC focused on the preferences of young patients with IA regarding the value of PROMs for shared decision making and monitoring, their content and mode of administration.
These EULAR PtC provide the first guidance to optimise the use of available PROMs for young people with IA. They should also serve as a companion for clinicians and researchers in rheumatology practice, and the relevant stakeholders when developing new PROMs and modifying existing PROMs. The OPs formulated by the TF underpin the value of PROMs as key elements to assess the impact of IA on the daily life of young people with IA, to aid the shared decision-making process. 9 The PtC encompass several areas such as information/education on PROMs, their purpose and the use of their results (PtC 1-3, 7), daily life activities relevant to young people (PtC 4-6) and the use of technology for health-related purposes (PtC 8). Some PtC might be applicable to young patients and to patients aged above 35 years. However, despite these potential similarities, the PtC presented were developed from the needs and priorities identified by young people with IA regarding PROMs. 7 Therefore, clinicians and researchers should strive to consider and embed the perspective of young people in the development of PROMS, to pave the way for a more inclusive, individualised and equal assessment of health, disease activity and well-being.
In summary, these are the first PtC for the use of PROMs in young patients with IA based on their own perspectives. We believe that the optimisation and harmonisation of PROMs used in daily practice could strengthen the relationship between patients and healthcare providers, facilitating shared decision Internal Medicine and Nephrology Unit, Department of Medicine, ASL Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, L'Aquila, Italy Twitter Paul Studenic @Stiddyo, Marios Kouloumas @kouloumasm, Elena Nikiphorou @ElenaNikiUK, Ivan Padjen @ivan_padjen and Simon Stones @ SimonRStones Acknowledgements This manuscript was reviewed and approved by all TF members and ratified by the EULAR Council. We would like to thank the focus group and survey participants for sharing their valuable perspectives. TF members are also grateful to EULAR PARE, Young PARE and EMEUNET for their support throughout the entire project.
Contributors All authors contributed to the work leading to the manuscript. The manuscript was drafted by PS and AA and revised and reviewed by all authors.  The assessment of a young person with IA should encompass items and domains of his/her daily life such as psychosocial issues, participation in social activities, education/work, sports and using technologic devices.
The schedule of PROMs assessment should be agreed on by the healthcare provider and the young person with IA, to balance frequency versus inconvenience.

Miscellaneous Miscellaneous Miscellaneous
Lilly, Novartis, Pfizer, Samsung Bioepis, Sanofi-Aventis, and UCB; grants from Lilly, Pfizer, and Sandoz, outside the submitted work. Patient consent for publication Not applicable.
Provenance and peer review Not commissioned; internally peer reviewed.
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