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肿瘤学实践中实施电子患者报告结局(ePRO)措施的基本障碍和考虑因素:结合现有文献对一项可行性研究的结果进行背景分析。

Essential barriers and considerations for the implementation of electronic patient-reported outcome (ePRO) measures in oncological practice: contextualizing the results of a feasibility study with existing literature.

作者信息

Kiderlen Til Ramón, Schnack Alexandra, de Wit Maike

机构信息

Department of Hematology, Oncology and Palliative Care, Vivantes Hospital Neukoelln, Berlin, Germany.

Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.

出版信息

Z Gesundh Wiss. 2022 Oct 28:1-18. doi: 10.1007/s10389-022-01767-3.

Abstract

AIM

Monitoring electronic patient-reported outcomes (ePRO) can provide various benefits to cancer patients, such as enhanced quality of life, reduction of hospital admissions, and even prolonged survival. Furthermore, ePRO might offer significant benefits to patients under antineoplastic treatment in the context of the current COVID-19 pandemic. However, evidence on feasibility of ePRO in routine cancer care and barriers met in a real-life setting remains limited.

SUBJECT AND METHODS

We conducted a feasibility study among patients diagnosed with multiple myeloma currently under antineoplastic treatment. Patients filled out weekly ePRO questionnaires and were followed up for 6 months. In case of adverse events, an alert was sent to the clinic. We assessed uptake and adherence, as well as subjective perceptions of patients and clinic staff. A semi-structured literature review was conducted to contextualize results.

RESULTS

Eleven patients were recruited and followed up for 6 months. Overall adherence was found at a high level and remained stable throughout the study period. Feedback from patients was positive; however, clinic staff expressed disappointment and frustration, criticising an increase of workload while not perceiving any benefit to the oncological treatment. Both findings were backed by evidence we found in literature.

CONCLUSIONS

Implementation of ePRO monitoring to routine cancer treatment seems to be feasible regarding patients' acceptance and compliance. However, integration of the tool into clinical workflow without increasing workload and deterring clinicians proves to be a major challenge.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10389-022-01767-3.

摘要

目的

监测电子患者报告结局(ePRO)可为癌症患者带来诸多益处,如提高生活质量、减少住院次数,甚至延长生存期。此外,在当前新冠疫情背景下,ePRO可能会给接受抗肿瘤治疗的患者带来显著益处。然而,关于ePRO在常规癌症护理中的可行性以及在现实环境中遇到的障碍的证据仍然有限。

对象与方法

我们对目前正在接受抗肿瘤治疗的多发性骨髓瘤患者进行了一项可行性研究。患者每周填写ePRO问卷,并随访6个月。如出现不良事件,会向诊所发出警报。我们评估了接受率和依从性,以及患者和诊所工作人员的主观感受。进行了半结构化文献综述以将结果置于背景中。

结果

招募了11名患者并随访6个月。总体依从性处于较高水平,且在整个研究期间保持稳定。患者的反馈是积极的;然而,诊所工作人员表示失望和沮丧,批评工作量增加但未感觉到对肿瘤治疗有任何益处。这两个发现都得到了我们在文献中找到的证据的支持。

结论

就患者的接受度和依从性而言,在常规癌症治疗中实施ePRO监测似乎是可行的。然而,在不增加工作量且不使临床医生望而却步的情况下将该工具整合到临床工作流程中被证明是一项重大挑战。

补充信息

在线版本包含可在10.1007/s10389-022-01767-3获取的补充材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b3e/9613453/3facb79a186b/10389_2022_1767_Fig1_HTML.jpg

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