Dear Editor,
Cherrez-Ojeda and colleagues provide important insights into the persistent underuse of patient-reported outcome measures (PROMs) in atopic dermatitis and chronic urticaria.1 Perhaps the most notable finding is not that PROMs remain underused, but that many physicians acknowledge their value while still not incorporating them into routine practice. This apparent paradox suggests that the challenge may extend beyond awareness, training, or consultation time alone.
PROM underuse is often viewed as an implementation problem. However, the PROMUSE study raises an alternative possibility. The principal obstacle may not be the collection of patient-reported information, but the limited influence of that information on clinical decisions. In many healthcare settings, clinicians are encouraged to collect increasing amounts of patient-centred data, yet treatment decisions, performance metrics, and care pathways continue to be driven primarily by clinician-defined indicators. Under these circumstances, PROMs risk becoming informationally valuable but operationally peripheral.
A practical consequence is that efforts to increase PROM use frequently focus on education, workflow redesign, and digital integration. While these strategies may improve data collection, they do not necessarily ensure that patient-reported information influences treatment decisions. Healthcare systems may therefore become increasingly effective at measuring patient experiences without becoming equally effective at responding to them.
This challenge is not unique to allergy care. Similar concerns have emerged across chronic disease management, where recognition of patient-centred outcomes has not always translated into their incorporation within decision-making frameworks.2,3 The resulting gap is not simply one of measurement but of consequence. Information generated by patients may continue to carry less weight than traditional biomedical indicators when clinical priorities, quality metrics, and healthcare incentives remain aligned with the latter.
Viewed from this perspective, PROM underuse may represent a symptom rather than the underlying condition. The PROMUSE study highlights a broader question for the future of allergy care: not whether more patient-reported outcomes should be collected, but whether patient-reported outcomes meaningfully alter what clinicians do. Without that transition from measurement to action, PROMs risk becoming another source of information that is valued, documented, and ultimately overlooked.
Funding
No specific funding was received for this correspondence.
Data availability
No new data were generated or analyzed.
Author contributions
Nav La and Schawanya K. Rattanapitoon conceptualized the hypothesis and drafted the manuscript. All authors contributed to critical revision and approved the final version.
Ethical considerations
Not applicable—this work is a commentary on previously published research.
Declaration of generative AI and AI-assisted technologies in the writing process
ChatGPT (OpenAI) was used solely for language editing and reference formatting after manual drafting. All conceptual and analytical content was developed independently by the authors.
Declaration of competing interest
The authors declare no financial or non-financial conflicts of interest.
Footnotes
Full list of author information is available at the end of the article
References
- 1.Cherrez-Ojeda I., Bousquet J., Giménez-Arnau A., et al. Why physicians underuse patient-reported outcomes in atopic dermatitis and chronic urticaria—Insights from the UCARE/ADCARE PROMUSE study. World Allergy Organ J. 2026;19 doi: 10.1016/j.waojou.2026.101398. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Weller K., Winders T., McCarthy J., et al. Urticaria voices: real-world experience of patients living with chronic spontaneous urticaria. Dermatol Ther. 2025;15(3):747–761. doi: 10.1007/s13555-025-01348-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Kirkham J.J., Williamson P. Core outcome sets in medical research. BMJ Med. 2022;1(1) doi: 10.1136/bmjmed-2022-000284. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
No new data were generated or analyzed.