Development of a tool to measure patient-oriented outcomes for Veterans with inflammatory arthritis initiating self-administered biologic therapies

Background Veterans Health Administration Centralized Specialty Medication Management (CSMM) clinics have positive financial and process outcomes but lack patient-oriented outcomes. This project developed a tool to evaluate patient-oriented outcomes among Veterans with inflammatory arthritis and/or psoriasis initiating biologic therapies. Methods Using validated questionnaires, a tool was constructed and piloted. Four rounds of cognitive interviews, with 2 Veterans each, were conducted. Pre- and post-CSMM clinic cognitive interviews were conducted with 2 Veterans initiating biologic therapy. The tool was piloted with patients initiating biologic therapy. Results The post-CSMM survey began with 55 questions. There was 1 pilot interview for readability, 8 cognitive interviews over 4 tool versions, and 2 pre- post-CSMM survey cognitive interviews; 18 questions were revised, 9 removed, and 7 added. No problematic questions were identified during the final cognitive interviews. In pre- post-CSMM cognitive interviews, no problematic questions were identified and both Veterans endorsed connection of the pre- and post-questions. The final post-CSMM survey had 53 questions and the pre-CSMM survey had 31 questions. In the pilot, the pre- and post-CSMM survey was administered to 23 Veterans. Between interviews 34 days and 1.7 CSMM appointments elapsed. Time to complete the pre-CSMM survey and post-CSMM survey was 21 and 26 min, respectively. There were no difficult or confusing questions identified in the pilot. Conclusion This project created a pre- and post-CSMM tool with high content validity to measure patient-oriented outcomes among Veterans with inflammatory arthritis and/or psoriasis initiating biologic therapy. Feasibility in conducting pre- and post-CSMM interviews using the tool was established.