Warrington Lorraine, Absolom Kate, Velikova Galina
Leeds Institute of Cancer Studies and Pathology, University of Leeds , Leeds , UK.
Acta Oncol. 2015 May;54(5):600-8. doi: 10.3109/0284186X.2014.995778. Epub 2015 Mar 9.
Modern cancer treatments have improved survival rates and changed the nature of cancer care. The acute and long-term physical and psychosocial comorbidities associated with treatment place increasing demands on healthcare services to provide suitable models of follow-up care for the survivor population.
We discuss the value and challenges of incorporating patient-reported outcome measures (PROMs) and eHealth interventions into routine follow-up care. We draw on our 15 years' experience of developing electronic systems for capturing patient-reported data in oncology settings, with particular reference to eRAPID a new online symptom reporting system for cancer patients. THE REDESIGN OF HEALTHCARE PATHWAYS: New stratified care pathways have been proposed for cancer survivors with an emphasis on supported self-management and shared care. THE POTENTIAL ROLE OF PROMS IN SURVIVORSHIP CARE PATHWAYS: PROMs can be used to evaluate rehabilitation services, provide epidemiological 'Big Data' and screen patients for physical and psychological morbidities to determine the need for further support. In addition, electronic PROMs systems linked to electronic patient records (EPRs) have the capability to provide tailored self-management advice to individual patients. INTEGRATION OF PROMS INTO CLINICAL PRACTICE: The successful clinical utilisation of PROMs is dependent on a number of components including; choosing appropriate questionnaires, developing evidence-based scoring algorithms, the creation of robust electronic platforms for recording and transferring data into EPRs, and training staff and patients to engage effectively with PROMs.
There is increasingly positive evidence for using PROMs and eHealth approaches to support cancer patients' care during treatment. Much of what has been learnt can be applied to cancer survivorship. PROMs integrated into eHealth platforms and with EPR have the potential to play a valuable role in the development of appropriate and sustainable long-term follow-up models for cancer survivors.
现代癌症治疗提高了生存率，改变了癌症护理的性质。与治疗相关的急性和长期身体及心理社会合并症对医疗服务提出了越来越高的要求，需要为幸存者群体提供合适的后续护理模式。
我们讨论将患者报告结局测量（PROMs）和电子健康干预措施纳入常规后续护理的价值和挑战。我们借鉴了15年来在肿瘤学环境中开发用于收集患者报告数据的电子系统的经验，特别提及了eRAPID，这是一个针对癌症患者的新在线症状报告系统。医疗保健途径的重新设计：已为癌症幸存者提出了新的分层护理途径，重点是支持自我管理和共享护理。PROMs在幸存者护理途径中的潜在作用：PROMs可用于评估康复服务、提供流行病学“大数据”以及筛查患者的身体和心理疾病，以确定是否需要进一步支持。此外，与电子病历（EPRs）相连的电子PROMs系统有能力为个体患者提供量身定制的自我管理建议。将PROMs整合到临床实践中：PROMs在临床的成功应用取决于多个要素，包括选择合适的问卷、开发基于证据的评分算法、创建强大的电子平台用于记录数据并传输到EPRs，以及培训工作人员和患者有效地参与PROMs。
越来越多的积极证据表明，使用PROMs和电子健康方法可在治疗期间支持癌症患者的护理。所学到的许多知识可应用于癌症幸存者护理。整合到电子健康平台并与EPR相连的PROMs有潜力在为癌症幸存者开发合适且可持续的长期后续模式中发挥重要作用。
