Regenstrief, IU Tool Designed to Track Early Symptoms of Chronic Conditions

May 16, 2019
The tool’s ability to monitor the burden of symptoms among patients with multiple comorbidities is the building block for developing next generation population health management, one researcher notes

A new tool developed by researchers at the Regenstrief Institute and Indiana University will aim to help providers track, and potentially identify, early onset of more complex and serious underlying issues that could otherwise go undetected.

The tool, called SymTrak, is designed to track symptoms such as pain, fatigue, sleep disturbance, memory problems, anxiety and depression in older adults, thus enabling clinicians to provide better care for the diseases potentially causing the symptoms, according to officials from the Regenstrief Institute, an Indiana-based health research institute.

Patrick O. Monahan, Ph.D., the principal investigator on the SymTrak study—and a Regenstrief Institute affiliated scientist, and a professor of biostatistics at the Indiana University School of Medicine—created SymTrak with a team of experts in symptoms and chronic conditions, with the idea that it would be a fast, easily-scored means to assess patient symptoms, as well as to be reliable both when completed by the patient or by an accompanying caregiver.

"There was no existing tool in primary care for tracking symptoms relevant for multiple chronic conditions that satisfied several clinical needs, which our tool does," Monahan attests. "It is clinically practical, covers multiple domains, isn't specific to one disease, and focuses on clinically actionable symptoms."

In the creation of the SymTrak questionnaire, Monahan and his team conducted several separate focus groups of patients, caregivers and providers to determine questions, domains and response options to be included in the tool. Clinical care assistants, patients and caregivers also participated in personal interviews, which helped researchers improve the tool's language and clarity, officials noted.

To validate the tool, Monahan and team recruited 600 individuals—200 patient/caregiver pairs and 200 patients without identified caregivers—and conducted assessments during a baseline period and again three months later. The SymTrak tool drew upon strengths of existing questionnaires that serve to assess depression, anxiety, and somatic symptoms.

"Pain, fatigue, sleep disturbance, anxiety and depression are not specific to any one disease and account for more than half of all primary care visits", said co-author Kurt Kroenke, M.D., a research scientist at the Regenstrief Institute, and a professor of medicine at the Indiana University School of Medicine. And older adults, these symptoms, as well as memory problems, often appear in clusters as a result of multiple chronic conditions and can gravely impact quality of life.

“The SymTrak's multifunctional and practical ability to monitor the burden of symptoms among patients with multiple comorbidities is the building block for developing next generation population health management," added co-author Malaz Boustani, M.D., of the Regenstrief Institute.