Abstract
BackgroundThe successful implementation of patient-reported outcomes (PROs) in clinical routine faces many challenges, first and foremost the lack of consideration thereof in the patient care process. The aim of this study will be to first identify relevant barriers and facilitators and then design suitable implementation strategies which will be evaluated to improve the effectiveness of a PRO measure assessment in inpatient and outpatient cancer routine care.MethodsDuring the preparation phase, interviews with oncological patients (N = 28) and medical staff (N = 4) as well as focus groups with medical staff (N = 18) across five different departments caring for cancer patients were conducted. On the basis of these, qualitative content analysis revealed relevant barriers and facilitators for implementation of PROs in cancer care. Subsequently, implementation strategies and a model of implementation were developed. In the study phase, implementation strategies will be evaluated based on nine different implementation outcomes in five different oncological clinics. Evaluation of the implementation process will take place during three months in each clinic and data will be conducted pre, while and post implementation of the PRO measure. Therefore a sample size of 60 participants of whom 30 staff members and 30 participants will be questioned using existing and newly developed implementation outcome evaluation instruments.DiscussionKey to improving the effectiveness of PRO assessment in the time-critical clinical environment is the utilization of easy-to-use, electronic PRO questionnaires directly linked to patients’ records thereby improving consideration of PROs in patient care. In order to validate the effectiveness of this implementation process further, an evaluation parallel to implementation following an observational study design with a mixed-methods approach will be conducted. This study could contribute to the development of adequate evaluation processes of implementation of PROs to foster sustainable integration of PRO measures into routine cancer care.Trial registrationThis study was registered at Open Science Framework (https://osf.io/y7xce/).
Highlights
The successful implementation of patient-reported outcomes (PROs) in clinical routine faces many challenges, first and foremost the lack of consideration thereof in the patient care process
healthrelated quality of life (HrQoL) is one major dimension assessed through PRO measures in oncological care [4]
The purpose of our study is to identify beneficial and inhibiting conditions for clinicians and patients to use a PRO measure assessing health-related quality of life in cancer patients in clinical routine
Summary
The successful implementation of patient-reported outcomes (PROs) in clinical routine faces many challenges, first and foremost the lack of consideration thereof in the patient care process. The aim of this study will be to first identify relevant barriers and facilitators and design suitable implementation strategies which will be evaluated to improve the effectiveness of a PRO measure assessment in inpatient and outpatient cancer routine care. PROs are selfassessment measures to collect information on healthrelated quality of life (HrQoL), physical discomfort or patient perceived health status [1]. In chronic diseases PROs play an important role to generate data on the patient experience [2]. As cancer patients often experience physical and psychosocial consequences of their disease and its treatment, evaluation of HrQoL is important to get a full understanding of patient’s needs [5]. Successful implementation of PROs in clinical routine faces many challenges. Integration and use of results of PRO measures in oncological care is lacking [7]
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