Measurement properties of the Portuguese version of the rheumatoid arthritis patient-reported experience measure (CQRA-PREM): a cross-sectional single center study
Authors:   Rheumatology Department, University Hospital Center of São João, Porto, Oliveira D ,   Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Rainho R ,   Department of Medicine of Faculty of Medicine, University of Porto, Porto, Bernardes M ,   Rheumatology Department, University Hospital Center of São João, Porto; Department of Medicine of Faculty of Medicine, University of Porto, Porto, Vaz C ,   Rheumatology Department, University Hospital Center of São João, Porto; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto; Department of Medicine of Faculty of Medicine, University of Porto, Porto, Costa L ,   Rheumatology Department, University Hospital Center of São João, Porto, Fonseca JA ,   CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto; Allergy Unit, Instituto and Hospital CUF, Porto; MEDIDA – Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Jácome C ,   CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto
Published: June 2024

Aims: to test the measurement properties of the Portuguese version of the Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) for patients with rheumatoid arthritis (RA). Methods: This cross-sectional clinical field study recruited adult patients with RA during rheumatology appointments of a Portuguese rheumatology center. Patients completed the Portuguese version of CQRA-PREM, composed of 7 domains and 24 questions. Sociodemographic characteristics, symptoms/disease duration, current treatment, Pain-Visual Analog Scale (VAS), Patient Global Assessment (PGA)-VAS and Health Assessment Questionnaire (HAQ) were also collected from the patient. Disease Activity Score for 28 joints with C-reactive Protein (DAS28-CRP) was recorded by the rheumatologist. The assessment of CQRA-PREM measurement properties followed the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) recommendations. Results: A total of 61 patients with RA were included. The domains in which patients showed better experience were the “Needs and preferences”, followed by “Coordination and Communication”. The domain “Information, education and self-care” was an identified area of improvement for providing patient-centered care. Ceiling effects were found in four domains of the CQRA-PREM. Internal consistency of all domains was considered good (α>0.7). Homogeneity was considered good for each question in all domains analyzed (0.30≤rp≤0.70). The divergent validity of the PREM was good, revealing that the domains were not correlated (Pain-VAS, HAQ, DAS28-CRP) or only weakly (PGA-VAS) correlated with clinical outcomes. Conclusions: The CQRA-PREM showed acceptable measurement properties and is a useful tool for evaluating quality of healthcare provided in daily practice, as perceived by RA patients in Portugal.