Mazariego C, Jefford M, Chan R J, Roberts N, Millar L, Anazodo A, Hayes S, Brown B, Saunders C, Webber K, Vardy J, Girgis A, Koczwara B
The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling street, Woolloomooloo, NSW, 2011, Australia.
Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
J Cancer Surviv. 2022 Feb;16(1):33-43. doi: 10.1007/s11764-021-01135-2. Epub 2022 Feb 2.
The aim of this study was to develop priority recommendations for the service level implementation of patient-reported outcomes (PROs) into clinical cancer care.
Development of draft guidance statements was informed by a literature review, the Knowledge to Action (KTA) implementation framework, and discussion with PRO experts and cancer survivors. A two-round modified Delphi survey with key stakeholders including cancer survivors, clinical and research experts, and Information Technology specialists was undertaken. Round 1 rated the importance of the statements and round 2 ranked statements in order of priority.
Round 1 was completed by 70 participants with round 2 completed by 45 participants. Forty-seven statements were rated in round 2. In round 1, the highest agreement items (>90% agreement) included those that focused on the formation of strong stakeholder partnerships, ensuring ongoing communication within these partnerships, and the use of PROs for improvement and guidance in clinical care. Items ranked as the highest priorities in round 2 included assessment of current staff capabilities and service requirements, mapping of workflows and processes to enable collection, and using collected PROs to guide improved health outcomes.
This stakeholder consultation process has identified key priorities in PRO implementation into clinical cancer care that include clinical relevance, stakeholder engagement, communication, and integration within the existing processes and capabilities.
Routine adoption of PRO collection by clinical cancer services requires multiple implementation steps; of highest priority is strong engagement and communication with key stakeholders including cancer survivors.
本研究的目的是为将患者报告结局（PROs）应用于临床癌症护理的服务水平实施制定优先建议。
通过文献综述、知识转化为行动（KTA）实施框架以及与PRO专家和癌症幸存者的讨论，制定指导声明草案。对包括癌症幸存者、临床和研究专家以及信息技术专家在内的关键利益相关者进行了两轮改进的德尔菲调查。第一轮对声明的重要性进行评分，第二轮按优先顺序对声明进行排序。
第一轮有70名参与者完成，第二轮有45名参与者完成。第二轮对47项声明进行了评分。在第一轮中，最高一致性项目（>90%的一致性）包括那些侧重于建立强大的利益相关者伙伴关系、确保这些伙伴关系内的持续沟通以及在临床护理中使用PROs进行改进和指导的项目。在第二轮中列为最高优先事项的项目包括评估当前工作人员的能力和服务需求、绘制工作流程和流程以实现收集，以及使用收集到的PROs来指导改善健康结局。
这一利益相关者咨询过程确定了将PROs应用于临床癌症护理的关键优先事项，包括临床相关性、利益相关者参与、沟通以及在现有流程和能力范围内的整合。
临床癌症服务机构常规采用PRO收集需要多个实施步骤；最优先的是与包括癌症幸存者在内的关键利益相关者进行强有力的参与和沟通。
