Abstract
The disease and treatment of patients with head and neck cancer can lead to multiple late and long-term sequelae. Especially pain, psychosocial problems, and voice issues can have a high impact on patients’ health-related quality of life. The aim was to show the feasibility of implementing an electronic Patient-Reported Outcome Measure (PROM) in patients with head and neck cancer (HNC). Driven by our department’s intention to assess Patient-Reported Outcomes (PRO) based on the International Classification of Functioning during tumor aftercare, the program “OncoFunction” has been implemented and continuously refined in everyday practice. The new version of “OncoFunction” was evaluated by 20 head and neck surgeons and radiation oncologists in an interview. From 7/2013 until 7/2017, 846 patients completed the PROM during 2,833 of 3,610 total visits (78.5%). The latest software version implemented newly developed add-ins and increased the already high approval ratings in the evaluation as the number of errors and the time required decreased (6 vs. 0 errors, 1.35 vs. 0.95 min; p<0.01). Notably, patients had different requests using PRO in homecare use. An additional examination shows that only 59% of HNC patients use the world wide web. Using OncoFunction for online-recording and interpretation of PROM improved data acquisition in daily HNC patients’ follow-up. An accessory timeline grants access to former consultations and their visualization supported and simplified structured examinations. This provides an easy-to-use representation of the patient’s functional outcome supporting comprehensive aftercare, considering all aspects of the patient’s life.
Highlights
Advanced head and neck cancer (HNC) mostly requires an aggressive multimodal treatment approach based on tumor resection and/or radio-chemotherapy
From 07/2013 until 7/2017, 3006 registered patient contacts had been documented in the database initiated by 846 patients (Figure 4)
A total number of 890 different oncological patients with 3,610 physician-to-patient contacts had been registered in our ENT-Department
Summary
Advanced head and neck cancer (HNC) mostly requires an aggressive multimodal treatment approach based on tumor resection and/or radio-chemotherapy. The survival rate of a subgroup of HNC patients has improved due to the higher vulnerability of human papillomavirus (HPV)associated disease to cisplatin-based radio-chemotherapy and the development of new surgical, radio-therapeutic and molecular therapy strategies. Patients undergoing treatment of HNC are usually included in standardized (NCCN-guideline conform) follow-up programs, recommended for five years [1, 2]. The purposes of post-therapeutic aftercare are early identification of recurrence, early detection of secondary primary cancer in the head and neck area, description of functional impairments, and management of complications [3]. Follow-up visits regularly focus on the detection of recurrence but usually are less attentive to the perception and documentation of functional impairments and QoL. A patient-centered approach to comprehensively assess the impact of treatment and care on function and QoL is necessary and should provide actionable information to the treating physician in near time, at best immediately
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