The determinants of dropping out of remote Patient-Reported Outcome (PRO)-based follow-up among patients with epilepsy: a prospective cohort study (Preprint)

BACKGROUND Patient-reported outcome (PRO) measures comprise an emerging field in healthcare. In the Central Denmark Region, epilepsy outpatients can participate in remote PRO-based follow-up by completing a questionnaire at home instead of attending a traditional outpatient appointment. This approach aims to encourage patient engagement and is used in approximately half of all epilepsy outpatient consultations. However, drop out in this type of follow-up can be a challenge. OBJECTIVE This study aimed to examine the association between potential self-reported determinants and dropout in remote PRO-based follow-up for patients with epilepsy. METHODS This prospective cohort study (N=2282) explored the association between dropout in remote PRO-based follow-up for patients with epilepsy and nine potential determinants covering three domains: health-related self-management, general and mental health status, and patient satisfaction. The associations were examined using multiple logistic regression analyses with adjustment for gender, age, education, and cohabitation. RESULTS A total of 770 patients (33.7%) dropped out of remote PRO-based follow-up over 5 years. A statistically significant association between all potential determinants and dropouts in PRO-based follow-up was identified. Patients with low social support had an OR of 2.02 (95%CI:1.38;3.50) for dropout. Patients rating health as poor had an OR of 2.17 (95% CI: 1.65; 2.85) for dropout. Similar estimates were identified for the remaining determinants in question. CONCLUSIONS Patients with reduced self-management, poor health status, and low patient satisfaction had higher odds of dropout in remote PRO-based follow-up. Further research is needed to determine the reasons for drop out. CLINICALTRIAL