Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Penn Center for Cancer Care Innovation, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Cancer. 2021 Aug 15;127(16):2980-2989. doi: 10.1002/cncr.33617. Epub 2021 May 4.
Using patient-reported outcomes for symptom monitoring in oncology has resulted in significant benefits for adult patients with cancer. The feasibility of this approach has not been established in the routine care of children with cancer.
The Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE) is an item library that enables children and caregivers to self-report symptoms. Ten symptom items from the Ped-PRO-CTCAE were uploaded to an online platform. Patients at least 7 years old and their caregivers were prompted by text/email message to electronically self-report daily during a planned hospitalization for chemotherapy administration. Symptom reports were emailed to the clinical team caring for the patient, but no instructions were given regarding the use of this information. Rates of patient participation and clinician responses to reports were systematically tracked.
The median age of the participating patients (n = 52) was 11 years (range, 7-18 years). All patients and caregivers completed an initial login, with 92% of dyads completing at least 1 additional symptom assessment during hospitalization (median, 3 assessments; range, 0-40). Eighty-one percent of participating dyads submitted symptom reports on at least half of hospital days, and 54% submitted reports on all hospital days. Clinical actions were taken in response to symptom reports 21% of the time. Most patients felt that the system was easy (73%) and important (79%). Most clinicians found symptom reports easy to understand and useful (97%).
Symptom monitoring using patient-reported outcome measures for hospitalized pediatric oncology patients is feasible and generates data valued by clinicians and patients.
在肿瘤学中使用患者报告的结局来进行症状监测，为癌症成年患者带来了显著的获益。但这种方法在儿童癌症的常规护理中是否可行尚未得到证实。
儿科患者报告结局版常见不良事件术语标准（Ped-PRO-CTCAE）是一个项目库，它使儿童及其照护者能够自我报告症状。从 Ped-PRO-CTCAE 中选择了 10 个症状项目，并将其上传到一个在线平台。至少 7 岁的患者及其照护者会通过短信/电子邮件提示，在计划进行化疗治疗的住院期间每天进行电子自我报告。症状报告通过电子邮件发送给照护患者的临床团队，但并未给出有关使用这些信息的说明。系统地跟踪了患者参与率和临床医生对报告的反应率。
参与研究的患者（n=52）的中位年龄为 11 岁（范围，7-18 岁）。所有患者及其照护者都完成了初始登录，92%的患者完成了至少 1 次额外的住院期间症状评估（中位数，3 次评估；范围，0-40 次）。81%的参与患者在至少一半的住院天数提交了症状报告，54%的患者在所有住院天数都提交了报告。临床团队有 21%的时间会根据症状报告采取行动。大多数患者认为该系统非常容易（73%）和重要（79%）。大多数临床医生认为症状报告易于理解且非常有用（97%）。
使用患者报告结局指标对住院儿科肿瘤患者进行症状监测是可行的，并且生成了临床医生和患者都看重的数据。
