Electronic Patient-reported Outcomes System Research Articles

Survivorship and long-term follow-up after allogeneic hematopoietic stem cell transplantation

Allogeneic hematopoietic cell transplantation (allo-HCT) is a curative treatment strategy; however, long-term survivors of allo-HCT are at risk of experiencing late adverse effects, including chronic graft-versus-host disease, immunocompromised status, endocrine diseases, secondary cancers, and psychosocial issues. Long-term follow-up (LTFU) clinics for patients who have undergone allo-HCT play a role in the screening and prevention of these late effects. We conducted a nationwide questionnaire survey to characterize the current operation of LTFU clinics in Japan and showed that the establishment rate of LTFU clinics in 188 participating centers was 63%. The influencing factors in the establishment or management of long-term follow-up clinics were analyzed. Several factors were extracted, such as "lack of human resources" and "patients' and physicians' lack of understanding of the importance of LTFU" as inhibiting factors and "utilization of tools" as a promoting factor. The development of common LTFU tools, introduction of an electronic patient-reported outcome system, and further increase in the number of certified staff might facilitate the establishment of an efficient and sustainable LTFU system.

Capturing Relevant Patient Data in Clinical Encounters Through Integration of an Electronic Patient-Reported Outcome System Into Routine Primary Care in a Boston Community Health Center: Development and Implementation Study.

BackgroundElectronic patient-reported outcome (ePRO) systems can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation.ObjectiveThis study aimed to implement an ePRO system that administers key health questionnaires in an urban community health center in Boston, Massachusetts.MethodsAn ePRO system that administers key health questionnaires was implemented in an urban community health center in Boston, Massachusetts. The system was integrated with the electronic health record so that medical providers could review and adjudicate patient responses in real-time during the course of the patient visit. This implementation project was accomplished through careful examination of clinical workflows and a graduated rollout process that was mindful of patient and clinical staff time and burden. Patients responded to questionnaires using a tablet at the beginning of their visit.ResultsOur program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model in terms of applying technological innovation to streamline clinical processes and improve patient care.ConclusionsOur program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model for application of technological innovation to streamline clinical processes and improve patient care.

Patient experiences of an electronic PRO tailored feedback system for symptom management following upper gastrointestinal cancer surgery

PurposeComplications following upper gastrointestinal (UGI) surgery are common. Symptom-monitoring following discharge is not standardized. An electronic patient-reported outcome (ePRO) system providing feedback to patients and clinicians could support patients and improve outcomes. Little is known about patients’ experiences of using such systems. This qualitative sub-study explored patients’ perspectives of the benefits of using a novel ePRO system, developed as part of the mixed methods eRAPID pilot study, to support recovery following discharge after UGI surgery.MethodsPatients completed the online ePRO symptom-report system post-discharge. Weekly interviews explored patients’ experiences of using ePRO, the acceptability of feedback generated and its value for supporting their recovery. Interviews were audio-recorded and targeted transcriptions were thematically analysed.ResultsThirty-five interviews with 16 participants (11 men, mean age 63 years) were analysed. Two main themes were identified: (1) reassurance and (2) empowerment. Feelings of isolation were common; many patients felt uninformed regarding their expectations of recovery and whether their symptoms warranted clinical investigation. Participants were reassured by tailored feedback advising them to contact their care team, alleviating their anxiety. Patients reported feeling empowered by the ePRO system and in control of their symptoms and recovery.ConclusionPatients recovering at home following major cancer surgery regarded electronic symptom-monitoring and feedback as acceptable and beneficial. Patients perceived that the system enhanced information provision and provided a direct link to their care team. Patients felt that the system provided reassurance at a time of uncertainty and isolation, enabling them to feel in control of their symptoms and recovery.

Capturing patient advance directives status in a community oncology practice using an electronic patient-reported outcomes (ePRO) system.

5 Background: The American Society of Clinical Oncology recommends that providers encourage early advance care planning with their patients; yet, many cancer patients do not have advance directives (ADs). A potential reason for low AD rates is inadequate communication between the provider and patient. To address this gap, we developed an outpatient clinic AD initiative for any stage cancer patients via an ePRO system. The AD module was designed to ensure patients are aware of ADs and to assess whether or not the patient had ADs, specifically a Living Will and/or a durable power of attorney and their interest in receiving information about ADs. The study purpose was to assess patient AD status at the patient’s initial visit to an oncology clinic. Methods: This study used a retrospective, observational design that involved use of PRO data collected via the Patient Care Monitor (PCM), a web-based ePRO system linked to electronic medical record data. All study data were collected as part of routine clinical care. All patients at an initial visit to an oncology clinic completed the PCM survey, including the AD module, via a handheld e-tablet. Results: Overall, 18,239 patients completed the AD module (mean age 62; 32% male/68% female; 55% married; 60% White, 36% Black). One third of all patients (30%) reported having an AD at the time of the initial visit to the oncology clinic, specifically 11% indicated having a Living Will and 19% a durable power of attorney. The remaining two-thirds (70%) indicated either NOT having an AD (58%) or not knowing if they had an AD (12%). Patients with ADs were more likely to be older (M= 69 v. 59 yrs) and White (77% v 20% Black) ps < .0001. Of the patients without ADs, 10% requested more information on ADs. These patients were more likely to be older (M= 61 v. 58 yrs), female (68% v 32%), Black (54% v 40% White) and non-married/non-partnered (53% v 47%); ps < .005. Conclusions: This study demonstrates that the majority of patients do not have ADs at the time of an initial visit to a community-based oncology practice. Using an ePRO system can be an innovative and non-threatening way to identify unmet needs of patients and link them to resources for developing advance directives.

Galcanezumab in episodic migraine: subgroup analyses of efficacy by high versus low frequency of migraine headaches in phase 3 studies (EVOLVE-1 & EVOLVE-2)

BackgroundPatients with high-frequency episodic migraine (HFEM) have a greater disease burden than those with low-frequency episodic migraine (LFEM). Acute treatment overuse increases the risk of migraine chronification in patients with HFEM. Galcanezumab, a humanized monoclonal antibody binding calcitonin gene-related peptide (CGRP), is effective for migraine prevention with a favorable safety profile. Here, we investigate whether there are differences in galcanezumab efficacy in patients with LFEM or with HFEM.MethodsData were pooled from two double-blind, placebo-controlled phase 3 trials; EVOLVE-1 and EVOLVE-2. Patients were 18–65 years old, experienced 4–14 monthly migraine headache days (MHDs) for ≥1 year prior, with onset at < 50 years of age. Migraine headaches were tracked via electronic patient-reported outcome system and randomization was stratified by low (LFEM; 4–7 monthly MHDs) or high (HFEM; 8–14 monthly MHDs) frequency. Subgroup analysis compared the HFEM and LFEM subgroups with a linear or generalized linear mixed model repeated measures approach.ResultsThe intent-to-treat patients (N = 1773) had a mean age of 41.3 years, were mostly white (75%), female (85%), and 66% of patients had HFEM. In both the LFEM and HFEM subgroups, the overall (Months 1–6) and monthly changes from baseline in monthly MHDs and monthly MHDs with acute medication use compared with placebo were statistically significantly reduced for galcanezumab 120-mg and 240-mg. Galcanezumab (120-mg and 240-mg) significantly decreased the overall and monthly MHDs with nausea and/or vomiting, and with photophobia and phonophobia versus placebo in patients with LFEM or HFEM. In both subgroups, the mean overall (Months 1–6) and monthly percentages of patients with ≥50%, ≥75%, and 100% reduction in monthly MHDs from baseline were statistically significantly greater in patients receiving either dose of galcanezumab versus placebo. Galcanezumab (120-mg and 240-mg) significantly improved the Migraine-Specific Quality of Life Questionnaire role function-restrictive domain score as well as the Migraine Disability Assessment total score versus placebo for patients with LFEM or HFEM. There were no significant subgroup-by-treatment interactions.ConclusionsGalcanezumab was as effective in patients with HFEM as in those with LFEM. Associated symptoms, quality of life, and disability were similarly improved in patients with HFEM or LFEM.Trial registrationNCT02614183, NCT02614196.

Understanding patient advance directives status in a community oncology practice using an electronic patient-reported outcomes (ePRO) system.

e23181 Background: The National Comprehensive Cancer Network and the American Society of Clinical Oncology recommend that providers encourage early advance care planning with their patients1; yet, many cancer patients do not have advance directives (ADs). A potential reason for low AD rates is inadequate communication between the provider and patient. To address this gap, we developed an outpatient clinic AD initiative for any stage cancer patients via an ePRO system. The AD module was designed to ensure that patients are aware of ADs and to assess whether or not the patient had ADs, specifically a Living Will and/or a durable power of attorney. The study purpose was to assess patient AD status at the patient’s initial visit to an oncology clinic. Methods: This study used a retrospective, observational design that involved use of PRO and clinical data collected via the Patient Care Monitor™ (PCM), a web-based ePRO system linked to electronic medical record data. All data used in this study were collected as part of routine clinical care. All patients at an initial visit to an oncology clinic completed the PCM survey, including the AD module, via a handheld e-tablet. Results: Overall, 9,682 patients completed the AD module (mean age 63; 31% male/69% female; 58% married; 62% White, 35% Black). Cancer type was known for 75% of all patients (29% breast, 11% hematologic, 7% lung, 7% colorectal, 3% prostate, 17% other types). One third of all patients (33%) reported having an AD at the time of the initial visit to the oncology clinic, specifically 24% indicated having a Living Will and 9% a durable power of attorney. The remaining two-thirds (67%) indicated either NOT having an AD (56%) or not knowing if they had an AD (11%). Patients with ADs were more likely to be older ( M=68 v. 60 yrs), male (38% v 31%), White (41% v 20% Black) and married/partnered (35% v 29%); ps &lt;.0001. Conclusions: This study demonstrates that the majority of patients do not have ADs at the time of an initial visit to a community-based oncology practice. Using an ePRO system can be an innovative and efficient way to identify unmet needs of patients and link them to resources for developing advance directives. 1Brown AJ, Shen MJ, Urbauer D, et al. Room for improvement: An examination of advance care planning documentation among gynecologic oncology patients. Gynecol Oncol. Sep 2016;142(3):525-530.

The relationship between household income and patient-reported symptom distress and quality of life in children with advanced cancer: A report from the PediQUEST study.

Children with advanced cancer experience high symptom distress, which negatively impacts their health-related quality of life (HRQOL). To the authors' knowledge, the relationship between income and symptom distress and HRQOL is not well described. The Pediatric Quality of Life and Symptoms Technology (PediQUEST) multisite clinical trial evaluated an electronic patient-reported outcome system to describe symptom distress and HRQOL in children with advanced cancer via repeated surveys. The authors performed a secondary analysis of PediQUEST data for those children with available parent-reported household income (dichotomized at 200% of the Federal Poverty Level and categorized as low income [<$50,000/year] or high income [≥$50,000/year]). The prevalence of the 5 most commonly reported physical and psychological symptoms was compared between groups. Multivariable generalized estimating equation models were used to test the association between household income and symptom distress and HRQOL. A total of 78 children were included in the analyses: 56 (72%) in the high-income group and 22 (28%) in the low-income group. Low-income children were more likely to report pain than high-income children (64% vs 42%; P=.02). In multivariable models, children from low-income families demonstrated a uniform trend toward higher total (βlow-high =3.1; 95% confidence interval [95% CI], -0.08 to 6.2 [P=.06]), physical (β=3.8; 95% CI, -0.4 to 8.0 [P=.09]), and psychological (β=3.46; 95% CI, -1.91 to 8.84 [P=.21]) symptom distress compared with children from high-income families. Low income was associated with a uniform trend toward lower total (β=-7.9; 95% CI, -14.8, to -1.1 [P=.03]), physical (β=-11.2; 95% CI, -21.2 to -1.2 [P=.04]), emotional (β=-5.8; 95% CI, -13.6 to 2.0 [P=.15]), social (β=-2.52; 95% CI, -9.27 to 4.24 [P=.47]), and school (β=-9.8; 95% CI, -17.8 to -1.8 [P=.03]) HRQOL. In this cohort of children with advanced cancer, children from low-income families were found to experience higher symptom burden and worse QOL.

Integrating Electronic Patient-Reported Outcome Measures into Routine HIV Care and the ANRS CO3 Aquitaine Cohort's Data Capture and Visualization System (QuAliV): Protocol for a Formative Research Study.

BackgroundEffective antiretroviral therapy has greatly reduced HIV-related morbidity and mortality, dramatically changing the demographics of the population of people living with HIV. The majority of people living with HIV in France are well cared for insofar as their HIV infection is concerned but remain at risk for age-associated comorbidities. Their long-term, potentially complex, and growing care needs make the routine, longitudinal assessment of health-related quality of life and other patient-reported outcomes of relevance in the current treatment era.ObjectiveWe aim to describe the development of a Web-based electronic patient-reported outcomes system for people living with HIV linked to the ANRS CO3 Aquitaine cohort’s data capture and visualization system (ARPEGE) and designed to facilitate the electronic collection of patient-reported data and ultimately promote better patient-physician communication and quality of care (both patient satisfaction and health outcomes).MethodsParticipants who meet the eligibility criteria will be invited to engage with the Web-based electronic patient-reported outcomes system and provided with the information necessary to create a personal patient account. They will then be able to access the electronic patient-reported outcomes system and complete a set of standardized validated questionnaires covering health-related quality of life (World Health Organization's Quality of Life Instrument in HIV infection, named WHOQOL-HIV BREF) and other patient-reported outcomes. The information provided via questionnaires will ultimately be presented in a summary format for clinicians, together with the patient’s HIV care history.ResultsThe prototype of the Web-based electronic patient-reported outcome system will be finalized and the first 2 formative research phases of the study (prototyping and usability testing) will be conducted from December 2017 to May 2018. We describe the sequential processes planned to ensure that the proposed electronic patient-reported outcome system is ready for formal pilot testing, referred to herein as phases 1a and 1b. We also describe the planned pilot-testing designed to evaluate the acceptability and use of the system from the patient’s perspective (phase 2).ConclusionsAs the underlying information technology solution, ARPEGE, has being developed in-house, should the feasibility study presented here yield promising results, the panel of services provided via the proposed portal could ultimately be expanded and used to experiment with health-promoting interventions in aging people living with HIV in hospital-based care or adapted for use in other patient populations.Trial RegistrationClinicalTrials.gov NCT03296202; https://clinicaltrials.gov/ct2/show/NCT03296202 (Archived by WebCite at http://www.webcitation.org/6zgOBArps)Registered Report IdentifierRR1-10.2196/9439

Implementation of an electronic patient reported outcome system in a prostate cancer urology clinic.

143 Background: The Prostate Clinic at Vancouver General Hospital recently implemented electronic Patient Reported Outcomes (ePRO) collection from prostate cancer patients (pts). The ePRO system was adopted from the University Health Network, Toronto. Our objective was to review the successes and challenges related to the implementation of the system during its first 6 months of use. Methods: All newly diagnosed pts, those going for a prostate biopsy, and pts booking surgery are asked to complete ePRO on iPads at their clinic appointment. The ePRO includes the EPIC-26, EQ-5D-5L, WHODAS 2.0 questionnaires and the Distress Thermometer. It takes about 4-5 minutes to complete the questions, and consent to be contacted about future prostate cancer research is also requested. Afterwards, pts complete ePROs at each clinic appointment. They receive a report summarizing that day’s responses in the context of previous responses. Results: Between 4-1-17 and 10-16-17, 360 pts were eligible to complete the ePRO. 311/360 pts (86.4%) filled out the ePRO at least once. Of the 49 who didn’t, 24 were missed by the coordinator and 21 were not referred by clinic staff. Only 4 pts (8.2%) refused to answer the ePRO. 18 of the 311 pts only partially answered the ePRO, most often due to the length of the questionnaires. 396 instances of ePRO were completed by 311 pts. WiFi connectivity issues were encountered 30/396 times, which prolonged ePRO completion time, and on 3 occasions resulted in patients refusing to complete ePRO. Conclusions: Implementation of the ePRO system into our urology clinic is a success based on a high completion and low refusal rate, and was organized mainly by a single individual. Challenges include training clinic staff to refer pts to complete ePROs at appropriate times, technical difficulties with WiFi connectivity, and the need to interact with each pt individually, which can be time consuming and result in lost data. Eventually, all pts will be trained to pick up an iPad and complete ePROs prior to each appointment. We found the system straightforward to use, and have updated our iPads with additional questionnaires. It is clear that systems collecting ePROs will become standard practice as technology improves and costs go down.

Validation of Pruritus Measures Gathered with the Electronic Patient-reported Outcome System MoPat.

In order to improve diagnosis and treatment, physicians require information about the social context and quality of life of their patients. The Center for Chronic Pruritus at the University Hospital Münster achieves this goal using the electronic patient-reported outcome system "Mobile Patient Survey", which assesses pruritus and quality of life measures. The aim of this study is to evaluate the consistency and reliability of such measures. A total of 42 patients, age range 19-82 years, participated in the study and were asked to assess the measures at baseline via a paper questionnaire, and to use the "Mobile Patient Survey" at baseline and after 1 h in order to test reliability. Statistical analysis was performed using coefficient rc for metric variables and weighted kappa κw for categorical variables. The internal consistency of all measures was unaffected. It was shown that 6 out of 7 measures can be assessed without loss of reliability. It is recommended that questionnaires for electronic usage are assessed for validity and reliability.

Usability Testing of an Electronic Patient-Reported Outcome System for Survivors of Critical Illness.

Web-based electronic patient-reported outcomes (ePRO) measures are increasingly used to facilitate patient-centered health assessments. However, it is unknown if ePRO completion is feasible for recently ill intensive care unit (ICU) survivors and their families. To develop and evaluate the usability of a novel ePRO system (ePRO to Support People and Enhance Recovery [ePROSPER]) among ICU survivors and their families within an ongoing clinical trial. Paper-based PROs were iteratively adapted to electronic forms (ePROs). Then, the usability of ePROSPER was assessed among 60 patients, their family members, and PRO and programming experts via questionnaires (eg, Systems Usability Scale), "think aloud" open-ended feedback, task completion times, and error rates. Input from patients and their families was used to incorporate user-experience modifications into ePROSPER. This feedback also led to inclusion of automated reminders for questionnaire completion and real-time alerts for staff triggered by high symptom levels. Median usability scores increased over testing cycles from 40 to 73 to 95, nearing the maximum score and showing excellent usability. All users completed ePROSPER within 20 minutes; 87% preferred it to a written version. ePROSPER was then implemented in a clinical trial without data errors. Automated ePRO systems can be successfully integrated in a post-ICU clinical trial setting. The value of integrating such systems in direct clinical care should be assessed in future studies.

Evaluation of an interactive electronic patient-reported outcome (e-PRO) system in outpatient with oral chemotherapy.

696 Background: Health Information Technology (HIT) is increasingly integrated in clinical cancer care. Simultaneously routine assessment of patient reported outcomes (PROs) has been shown to reliably improve symptom management, identification of psychosocial problems and patient-provider communication. Methods: This study is a single center experience of a multicenter randomized study for the development and validation of an interactive e-PRO tool (RemeCoach). After obtaining informed consent, outpatients, using oral anti-cancer treatment, recorded their medication intake and 17 clinical parameters using this E-PRO tool. The device allowed real time data collection and communication with other care providers via a central platform. The registered data were processed by an algorithm, this algorithm stratifies the data into different grades according to international standards of care (CTCAE v4.0) and clinical importance. Patient clinical and demographic information is collected from medical records and analyzed using descriptive statistics. Results: 21 Patients were included, 62% male, mean age 59,2 (range 38-79). 38% Of patients used capecitabine, 52% regorafenib, 5% pazopanib and 5% sunitinib. Most common symptoms cited were fatigue (95%), myalgia and joint pain (75%) and cough (62%). Median pain score : 3 (Brief Pain Inventory(BPI)). Treatment compliance using the e-PRO was 75%. Conclusions: This study confirms the feasibility of the program, in an outpatient setting. This e-tool provides a means to register compliance, early symptoms of disease and toxicity of treatment.The compliance to the e-PRO tool will be confirmed, with further development of this program in a multicenter, randomized design. Evaluation of quality of life PRO-measurements and further exploration of the relationship between optimal pharmacovigilance and improvement of patient’s outcome will ensue.

Enabling symptom self-management via use of an electronic patient-reported outcomes (ePRO) system to increase self-efficacy of patients with cancer receiving active chemotherapy treatment

Enabling symptom self-management via use of an electronic patient-reported outcomes (ePRO) system to increase self-efficacy of patients with cancer receiving active chemotherapy treatment

Usability Testing of an Electronic Patient-Reported Outcome System for Survivors of Critical Illness

Usability Testing of an Electronic Patient-Reported Outcome System for Survivors of Critical Illness

PIH60 - Usability Testing of an Integrated Glucometer and Handheld Electronic Patient-Reported Outcome System

PIH60 - Usability Testing of an Integrated Glucometer and Handheld Electronic Patient-Reported Outcome System

Feasibility of Conducting a Palliative Care Randomized Controlled Trial in Children With Advanced Cancer: Assessment of the PediQUEST Study

ContextPediatric palliative care randomized controlled trials (PPC-RCTs) are uncommon. ObjectivesTo evaluate the feasibility of conducting a PPC-RCT in pediatric cancer patients. MethodsThis was a cohort study embedded in the Pediatric Quality of Life and Evaluation of Symptoms Technology Study (NCT01838564). This multicenter PPC-RCT evaluated an electronic patient-reported outcomes system. Children aged two years and older, with advanced cancer, and potentially eligible for the study were included. Outcomes included: pre-inclusion attrition (patients not approached, refusals); post-inclusion attrition (drop-out, elimination, death, and intermittent attrition (IA; missing surveys) over nine months of follow-up); child/teenager self-report rates; and, reasons to enroll/participate. ResultsOver five years, of the 339 identified patients, 231 were eligible (in 22, we could not verify eligibility); 84 eligible patients were not approached and 43 declined participation. Patients not approached were more likely to die or have brain tumors. We enrolled 104 patients. Average enrollment rate was one patient per site per month; shortening follow-up from nine to three months (with optional re-enrollment) increased recruitment by 20%. A total of 87 patients completed the study (24 died) and 17 dropped out. Median IA was 41% in the first 20 weeks of follow-up and more than 60% in the eight weeks preceding death. Child/teenager self-report was 94%. Helping others, low burden procedures, incentives, and staff attitude were frequent reasons to enroll/participate. ConclusionA PPC-RCT in children with advanced cancer was feasible, post-inclusion retention adequate; many families participated for altruistic reasons. Strategies that may further PPC-RCT feasibility include: increasing target population through large multicenter studies, approaching sicker patients, preventing exclusion of certain patient groups, and improving data collection at end of life.

Feasibility of Frequent Patient-Reported Outcome Surveillance in Patients Undergoing Hematopoietic Cell Transplantation

Patient-reported outcomes (PROs), including symptoms and health-related quality of life (HRQOL), provide a patient-centered description of hematopoietic cell transplantation (HCT)-related toxicity. These data characterize the patient experience after HCT and may have prognostic usefulness for long-term outcomes after HCT. We conducted a study of 32 patients after HCT (10 autologous HCT recipients, 11 full-intensity conditioning allogeneic HCT recipients, and 11 reduced-intensity conditioning allogeneic HCT recipients) to determine the feasibility of weekly electronic PRO collection from HCT until day (D) +100. We used questions from the PRO version of the Common Terminology Criteria for Adverse Events to capture symptoms, and the Patient-Reported Outcomes Measurement Information System Global Health scale to measure physical and mental HRQOL. The vast majority (94%) of patients used the electronic PRO system, with only 6% opting for paper-and-pencil only. The median weekly percentage of participants who completed the surveys was 100% in all cohorts through hospital discharge, and remained 100% for the autologous HCT and reduced-intensity allogeneic HCT cohorts through D+100. Patients were satisfied with the electronic system, giving high marks for readability, comfort, and questionnaire length. Symptom severity varied by absolute level and type of symptom across the 3 cohorts, with the full-intensity allogeneic HCT cohort exhibiting the greatest median overall symptom severity, peaking at D+7. Median physical health HRQOL scores decreased with time in the 3 cohorts, and HRQOL was generally correlated with overall symptom severity. Our results demonstrate the feasibility of frequent electronic PROs in the early post-HCT period. Future studies in larger populations to explore predictive models using frequent PRO data for outcomes, including long-term HRQOL and survival, are warranted.

A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery

PurposeThe purposes of this study are to evaluate the feasibility of capturing patient-reported outcomes (PROs) electronically and to identify the most common distressing symptoms in women recovering from major gynecologic cancer surgery. MethodsThis was a prospective, single-arm pilot study. Eligible participants included those scheduled for a laparotomy for presumed or known gynecologic malignancy. Patients completed a Web-based “STAR” (Symptom Tracking and Reporting for Patients) questionnaire once preoperatively and weekly during the 6-week postoperative period. The questionnaire consisted of the patient adaptation of the NCI CTCAE 3.0 and EORTC QLQ-C30 3.0. When a patient submitted a response that was concerning, an automated email alert was sent to the clinician. The patient's assessment of STAR's usefulness was measured via an exit survey. ResultsForty-nine patients completed the study. The procedures included the following: hysterectomy±staging (67%), resection of tumor (22%), salpingo-oophorectomy (6%), and other (4%). Most patients (82%) completed at least 4 sessions in STAR. The CTC generated 43 alerts. These alerts resulted in 25 telephone contacts with patients, 2 ER referrals, one new appointment, and one pharmaceutical prescription. The 3 most common patient-reported symptoms generating an alert were as follows: poor performance status (19%), nausea (18%), and fatigue (17%). Most patients found STAR useful (80%) and would recommend it to others (85%). ConclusionApplication of a Web-based, electronic STAR system is feasible in the postoperative period, highly accepted by patients, and warrants further study. Poor performance status, nausea, and fatigue were the most common distressing patient-reported symptoms.

A prospective study of the feasibility and acceptability of a web-based, electronic patient-reported outcomes system in assessing patient recovery after major gynecologic cancer surgery

Objective: To evaluate the feasibility and patient (pt) acceptability of electronic capture of patient-reported outcomes (PROs) and to identify the most common reported distressing symptoms in women recovering from major gynecologic cancer surgery.

A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery

A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery