Development and Validation of a Patient Reported Experience Measure (PREM) for Patients with Rheumatoid Arthritis (RA) and other Rheumatic Conditions
Objectives: Patient experience is not routinely measured in rheumatoid arthritis (RA) and no
accepted standardised Patient Reported Experience Measures (PREM) tools currently exist. Commissioning
for Quality in Rheumatoid Arthritis (CQRA) has developed, piloted and validated PREMs for
RA and other rheumatic conditions.
Methods: Focus groups were held with RA patients to identify key elements of the patient experience. These were mapped
against the UK Department of Health Patient Experience Framework and a PREM questionnaire developed with questions
specifically relating to RA and rheumatology services. The RA PREM was piloted and Cronbach’s alpha used to assess
internal consistency. The PREM was modified to capture experience of patients with other rheumatic conditions and further
Results: Ten UK sites and 524 patients were included in the RA PREM pilot and validation analysis. The RA PREM reliably
captured RA patient experience and had good construct validity. Cronbach’s alpha within the multiquestion domains
ranged from 0.61 to 0.90 and the percentage agreement ranged from 22.5% to 70.4% with overall care. The modified
PREM was evaluated in 11 UK sites and 110 patients with a range of rheumatic conditions. Cronbach’s alpha ranged
from 0.76 to 0.91 and the percentage agreement similarly ranged from 70% to 90% with the question on overall care.
Conclusions: The RA PREM and the modified PREM provide new valuable validated tools for capturing the patient experience
in a range of rheumatic conditions. The RA PREM is currently being used in a UK National Clinical Audit of
Rheumatoid and Early Inflammatory Arthritis.
Keywords: Patient Reported Experience Measure, rheumatoid arthritis.
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