Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Acta Oncol. 2021 Apr;60(4):434-443. doi: 10.1080/0284186X.2021.1891281. Epub 2021 Mar 2.
Patients with ovarian cancer often experience substantial health problems and side effects resulting in reduced quality of life (QoL). Different models of using patient-reported outcome measures (PROMs) during follow-up may improve the quality of care. This national, multicenter observational study investigated the effect of active use of PROMs on patient-perceived involvement, satisfaction with care, unmet needs, and QoL during follow-up of ovarian cancer.
Ovarian cancer patients were recruited at the end of primary treatment at eight centers in Denmark. During 18 months of follow-up patients repeatedly completed European Organization for Research and Treatment of Cancer (EORTC) questionnaires covering health related QoL and symptoms. At the sites using PROMs actively (ACT), the clinician had access to an overview of the patient's scores during the clinical encounter. Clinicians using PROMs passively were alerted in case of severe development of symptoms. Following each encounter, patients evaluated their health service experience by completing the CollaboRATE scale of involvement in decision making, the Patient Experience Questionnaire, and ad hoc questions covering patient-perceived usefulness of the PROMs.
A total of 223 patients were enrolled, i.e., 168 (75.3%) at five sites using ACT and 53 (23.8%) at three sites using them passively. We found no statistically significant difference in involvement in the decision making, satisfaction with care, unmet needs, and QoL between the two groups. The majority of patients found it useful to complete the PROMs, although it did not seem to significantly support them in raising issues with the oncologist.
Active use of PROMs did not improve patients' experience of involvement in follow-up care as compared to passive use.
卵巢癌患者常经历严重的健康问题和副作用,导致生活质量(QoL)下降。在随访期间使用患者报告结局测量(PROMs)的不同模式可能会提高护理质量。本项全国性、多中心观察性研究旨在探讨积极使用 PROMs 对卵巢癌患者随访期间感知参与度、对护理满意度、未满足需求和 QoL 的影响。
在丹麦的 8 个中心,在初始治疗结束时招募卵巢癌患者。在 18 个月的随访期间,患者反复填写欧洲癌症研究与治疗组织(EORTC)问卷,涵盖健康相关 QoL 和症状。在积极使用 PROMs 的中心(ACT),临床医生在临床就诊时可以查看患者的评分概况。在被动使用 PROMs 的中心,如果症状严重发展,临床医生会收到警报。每次就诊后,患者通过填写参与决策的 CollaboRATE 量表、患者体验问卷以及涵盖患者对 PROMs 感知有用性的特定问题,评估其医疗服务体验。
共纳入 223 例患者,其中 168 例(75.3%)在 5 个使用 ACT 的中心,53 例(23.8%)在 3 个使用被动 PROMs 的中心。两组在决策参与度、对护理的满意度、未满足的需求和 QoL 方面均无统计学差异。大多数患者认为填写 PROMs 很有用,尽管这似乎并未显著支持他们向肿瘤医生提出问题。
与被动使用相比,积极使用 PROMs 并未改善患者对随访护理的参与体验。