Katsura Hideyuki, Zenitani Satoko
Dept. of Pharmacy, Komatsu Municipal Hospital.
Gan To Kagaku Ryoho. 2024 Apr;51(4):353-367.
The Common Terminology Criteria for Adverse Events has been used to evaluate adverse events in oncology. However, it has been shown that medical practitioners who assess adverse events tend to underestimate symptoms more than the patients themselves who experience them, and monitoring of patient-reported outcomes(PROs)is considered essential to achieve patient-centered care. PRO is defined as"any report of a patient's health status obtained directly from the patient, without interpretation by a clinician or anyone else". PROs have been routinely collected in clinical practice using paper and pencil, but they can also be collected more easily and efficiently in the form of electronic PROs(ePROs)using tablets and smartphones. The ePRO system enables remote symptom monitoring and intervention, when necessary, as PROs entered by the patient are shared with the health care provider even when not in person, which not only improves the patient's quality of life but also has been reported to increase overall survival. In Japan, ePROs that can be used in routine medical care are already available, but they have not yet been widely adopted. This article outlines the necessity and usefulness of ePRO monitoring in the treatment of cancer patients, problems and solutions for its introduction and dissemination, and prospects in daily clinical practice.
不良事件通用术语标准已被用于评估肿瘤学中的不良事件。然而,研究表明,评估不良事件的医生往往比经历这些事件的患者本身更容易低估症状,因此,监测患者报告结局(PRO)被认为是实现以患者为中心的护理的关键。PRO被定义为“直接从患者处获得的关于其健康状况的任何报告,未经临床医生或其他任何人的解读”。在临床实践中,PRO通常通过纸笔方式常规收集,但也可以使用平板电脑和智能手机以电子PRO(ePRO)的形式更轻松、高效地收集。ePRO系统能够进行远程症状监测,并在必要时进行干预,因为即使患者与医疗服务提供者不在同一地点,患者输入的PRO也会与他们共享,这不仅提高了患者的生活质量,而且据报道还能提高总生存率。在日本,可用于常规医疗护理的ePRO已经存在,但尚未得到广泛应用。本文概述了ePRO监测在癌症患者治疗中的必要性和实用性、引入和推广过程中存在的问题及解决方案,以及在日常临床实践中的前景。