Assessment of patient reported outcomes (PROs) completion patterns in patients with cancer: Examining real-world data.

Abstract

6609 Background: Use of Patient Reported Outcomes (PROs) in clinical practice plays a major role in improving care, quality of life, hospitalization, emergency room visits and consequently improving overall survival. However, robust information on real-time assessment of PROs in cancer patients is insufficient, as most available data are limited to specific populations enrolled in clinical trials. This thereby increases disparities among minorities of race, age, and socioeconomic status, creating a barrier between the benefits of PROs and these underserved populations. This study examines the response rates, patterns and characteristics of patients completing PROs in a tertiary cancer center. Methods: Patients with a cancer diagnosis and an oncologic provider visit at a tertiary cancer center were offered an opportunity to complete Patient Reported Outcome Measures (PROMs) between August 2020 and July 2022.We used the National Institute of Health’s computer adaptive tests Patient-Reported Outcomes Measurement Information System (PROMIS) instruments in pain interference, physical function, fatigue, and depression. Seven days prior to their clinical appointment, patients were assigned the PROMIS instruments in MyChart, then offered in-clinic completion with a tablet at check-in, if not completed online. A decision tree model was employed to assess the factors that may influence patients' PROMs completion (age, gender, race, marital status, insurance, stage, comorbidity score, and provider specialty and location). Results: A total of 8,535 patients were offered the PROMIS CAT version 2.0 instrument during the study period. The two most important factors that determine whether a patient completed PROMs in order of importance were provider specialty and patient race. Patients were more likely to complete PROMs if they had a visit with a provider in Radiation Oncology (RC) or Surgery specialty compared with Medicine or Supportive Oncology specialty (40.86% versus 29.68%). Among patients who had a visit with a provider in RC or Surgery specialty, there was a better chance of PROMs completion with White race compared to Black or Other races (45.83% versus 33.69%). Of those who had a visit with a provider in Medicine or Supportive Oncology specialty, there was a better chance of PROMs completion with Other or White races compared to Black race (32.40% versus 22.19%). Conclusions: We found that provider specialty and patient race were the most important factors influencing patients’ PROMs completion. In order to realize the full benefit of PROs in patient care, multilevel interventions can be employed to increase patient-provider utilization of PROs. Moreover, efforts should focus on a patient-centered design to address patient and provider barriers impeding PROs accessibility and completion.