肿瘤学中的患者报告结局:观念转变——系统综述。

Patient reported outcomes in oncology: changing perspectives-a systematic review.

机构信息

Health Sciences Faculty, Fernando Pessoa University (UFP-FCS), Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.

Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal.

出版信息

Health Qual Life Outcomes. 2022 May 21;20(1):82. doi: 10.1186/s12955-022-01987-x.

Abstract

In public health context, oncology is associated with severe negative impact on patients and on their relatives' quality of life. Over the last decades, survival has remained at 50% worldwide for some tumor locations. Patient reported outcomes (PROs) assessment and, the corresponding use in clinical practice, help establishing patient individualized profiling involving caregivers. The purpose of this systematic review was to examine critical success factors for PROs assessment in daily clinical oncology practice. Additionally, we investigated how PROs collection can change oncology perspectives for patients and caregivers. According to PRISMA guidelines, 83 studies were included in this systematic review, whether related with implementation in daily clinical practice or associated with its use in oncology. PROs assessment gathers multi-professional teams, biomedical and clinical expertise, patients, families and caregivers. Institutional involvement, first line for caregiver's adherence, team continuous formation, encompassing training and support, design of clear workflows, continuous monitoring, and data analysis are crucial for implementation. PROs measures are decisive in oncology. Several items were improved, including caregiver-patient-physician communication, patient risk groups identification, unmet problems and needs detection, disease course and treatment tracking, prognostic markers, cost-effectiveness measurement and comfort/support provision for both patients and caregivers. Routine assessment and implementation of PROs in clinical practice are a major challenge and a paradigm transformation for future.

摘要

在公共卫生领域,肿瘤学与患者及其亲属生活质量的严重负面影响相关。在过去几十年中,全球某些肿瘤部位的生存率仍保持在 50%。患者报告结局(PROs)评估及其在临床实践中的应用有助于确定涉及照护者的患者个体化特征。本系统评价的目的是探讨日常临床肿瘤学实践中 PROs 评估的关键成功因素。此外,我们还研究了 PROs 收集如何改变患者和照护者对肿瘤学的看法。根据 PRISMA 指南,本系统评价共纳入 83 项研究,无论其与日常临床实践的实施相关,还是与在肿瘤学中的应用相关。PROs 评估汇集了多专业团队、生物医学和临床专业知识、患者、家庭和照护者。机构参与、照护者依从性的第一线、团队的持续组建、包括培训和支持、清晰工作流程的设计、持续监测和数据分析对于实施至关重要。PROs 测量在肿瘤学中具有决定性作用。改善了包括医患沟通、患者风险群体识别、未满足的问题和需求检测、疾病过程和治疗跟踪、预后标志物、成本效益测量以及患者和照护者的舒适度/支持提供等多个方面。PROs 在临床实践中的常规评估和实施是未来的主要挑战和范式转变。

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