• Patrick O Monahan, Kurt Kroenke, Christopher M Callahan, Tamilyn Bakas, Amanda Harrawood, Phillip Lofton, Danielle Frye, Claire Draucker, Timothy Stump, Debra Saliba, James E Galvin, Amanda Keegan, Mary G Austrom, and Malaz Boustani.
• Indiana University School of Medicine, Indianapolis, IN, USA. pmonahan@iu.edu.
• J Gen Intern Med. 2019 Jun 1; 34 (6): 915-922.

BackgroundA clinically practical, brief, user-friendly, multi-domain self-report and caregiver-report tool is needed for tracking actionable symptoms in primary care for elderly patients with multiple chronic conditions (MCCs).ObjectiveDevelop and assess usability, administration time, and internal reliability of SymTrak.Design And ParticipantsPhase I: legacy instruments, content validity, analyses of existing data, focus groups (physicians, nurses, patients, informal caregivers), and Think Aloud interviews (patients, caregivers) were used to develop SymTrak. Phase II (pilot feasibility study): 81 (27 patient-caregiver dyads, 27 patients without an identified caregiver) participants were self-administered SymTrak in clinic.Main MeasuresSymTrak and demographic questions.Key ResultsConsistent themes emerged from phase I focus groups. Ambiguous wording was corrected with Think Aloud feedback. In phase II, patients and caregivers preferred circling words instead of numbers for item response options. SymTrak self-administration completion time in clinic was brief; mean was 2.4, 3.0, and 3.3 min for the finalized circlingwords version, respectively, for caregivers, dyadic patients, and patients without a caregiver; and the maximum was 6.2 min for any participant. Usability questionnaire ratings were high. Cronbach's alpha for the SymTrak 23-item total score was 0.86, 0.79, and 0.81 for caregivers, dyadic patients, and patients without a caregiver, respectively.ConclusionsSymTrak demonstrates content validity, positive qualitative findings, high perceived usability, brief self-administered completion time, and good internal reliability.

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