Use cases in Urology
Why use patient-reported outcomes in urology
Many urological conditions are treated with the primary intention of improving functional, symptomatic and quality-of-life outcomes. For example, in the treatment of BPH the outcomes of interest are whether the patient noticed a lasting improvement in urinary symptoms, the ability to go about their every day life unimpaired and ultimately whether their quality-of-life was improved. Similarly, many urological treatments have side-effects that can have significant impact on a patient’s life and it is crucial that we have insight.
Patient-reported outcomes offer a lens with which to capture and systematically measure these outcomes in your practice. That data can be made accessible to front-line clinicians, care managers to provide real-time feedback, to guide proactive and patient-centered care and to ultimately improve patient outcomes.
What measures are out there?
There are several validated measures available for urology patients. Most focus around urinary symptoms such as the International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire (OABq), the King’s Health Questionnaire, the International Consultation on Incontinence Modular Questionnaire (ICIQ) and the American Urological Association BPH Symptom Score. Measures like the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) can be used to assess prostate cancer quality of life. General health measures such as the PROMIS-10, EQ-5D and SF-36 can also be used to assess general health related quality of life.
Starting a program in your practice
Getting started is easy and we’d encourage you to register on the platform and start testing it with a few of your patients to get familiar. In order to stand up a comprehensive outcomes program we recommend a few key steps that are outlined in our one page 8-step summary Outcomes: Getting Started .
Illustrative Use Case: Benign Prostatic Hyperplasia
BPH is a common condition affecting older men that causes lower urinary symptoms and can have a profound impact impact on a patient’s life. Thankfully there are a wide array of effective treatments available ranging from watchful waiting and medical therapy through to surgical therapies and the gold standard of transurethral resection. The AUA Symptom Index is a cornerstone of BPH severity assessment, so one practice decided to routinely monitor the AUA-SI for patients seen in their BPH clinic. Patients completed the AUA-SI every 4 weeks and the results were used to guide treatment in the clinic and identify early failures of medical therapy. For patients who underwent surgical treatment, pre and post surgical scores were examined and published on the practice’s website. For patients with mild symptoms on long-term medical therapy, they continued remote monitoring and called patients back if their scores significantly declined.
Illustrative Use Case: Overactive Bladder
Overactive bladder is a common condition in both men and women that can have a significant impact on quality of life. It can be difficult to treat and has multiple treatment options that start with behavioral therapies and can progress to pharmacologic management, nerve stimulation, neuromodulation and botox injections. A practice wanted gain a better understanding of their outcomes and start making more data driven choices in treatment escalation. They used the OAB-q to start routinely measuring outcomes at regular intervals, feeding that data back to the point of care to guide conversations. As they accumulated more data they began to use it for shared-decision making, helping set expectations around real-world improvements they had seen with different treatments in matched patients.