Development and Feasibility of SymTrak, aMulti-domain Tool for Monitoring Symptoms of Older Adults in Primary Care

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, Malaz Boustani

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: A 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). Objective: Develop and assess usability, administration time, and internal reliability of SymTrak. Design and Participants: Phase 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 Measures: SymTrak and demographic questions. Key Results: Consistent 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. Conclusions: SymTrak demonstrates content validity, positive qualitative findings, high perceived usability, brief self-administered completion time, and good internal reliability.

Original languageEnglish (US)
Pages (from-to)915-922
Number of pages8
JournalJournal of general internal medicine
Issue number6
StatePublished - Jun 15 2019
Externally publishedYes


  • aging
  • chronic disease
  • primary care
  • psychometrics
  • self-management
  • symptoms

ASJC Scopus subject areas

  • Internal Medicine


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