Price Sarah N, Willis Alana R, Hensley Amy, Hyson Jill, Sohl Stephanie J, D'Agostino Ralph B, Farris Michael, Petty W Jeffrey, de Hoyos Alberto, Weaver Kathryn E, Wentworth Stacy
Department of Social Sciences and Health Policy, Wake Forest University School of Medicine.
Department of Biostatistics and Data Science, Wake Forest University School of Medicine.
Clin Lung Cancer. 2025 Jan;26(1):e41-e54. doi: 10.1016/j.cllc.2024.09.008. Epub 2024 Oct 1.
The number of early-stage lung cancer survivors (LCS) is increasing, yet few survivorship programs address their specific needs. We developed a workflow to transition early-stage LCS to dedicated lung survivorship care and comprehensively identify and address their needs using electronic patient-reported outcomes (ePROs).
A lung cancer multidisciplinary team developed a workflow (eg, referrals, survivorship care plan delivery, documentation, orders, tracking, ePROs, and surveillance) for a survivorship clinic staffed by Advanced Practice Providers (APPs). ePROs included the NCCN Distress Thermometer, PROMIS-29, and investigator-developed patient satisfaction items. Patient characteristics, ePROs, and referrals are described; chi-square and t-tests examined ePRO completion by patient characteristics and compared PROMIS-29 domains by treatment modality and to a national sample.
From January 2020-March 2023, 315 early-stage LCS completed a survivorship orientation visit. Patient satisfaction was high; 75% completed ePROs. Females were overall less likely to complete ePROs than males; male, age 65+, Black or other race, and rural patients were more likely to complete ePROs in clinic versus online. Patients reported lower symptom burden compared to a general population of early-stage LCS in the United States; scores were similar regardless of treatment modality. Rates of moderate-severe symptoms ranged from 6% (depression) to 42% (poor physical function); ≤ 20% had a referral placed.
A referral-based, APP-staffed survivorship clinic model for early-stage LCS which includes ePROs to identify specific needs is acceptable to patients. Future work should include outreach to female LCS and increasing supportive care referrals and acceptability to further address early-stage LCS reported needs.
早期肺癌幸存者（LCS）的数量正在增加，但很少有生存计划能满足他们的特定需求。我们开发了一种工作流程，将早期LCS患者过渡到专门的肺癌生存护理，并使用电子患者报告结局（ePROs）全面识别和满足他们的需求。
一个肺癌多学科团队为一个由高级实践提供者（APPs）配备人员的生存诊所制定了一个工作流程（例如，转诊、生存护理计划交付、文档记录、医嘱、跟踪、ePROs和监测）。ePROs包括NCCN苦恼温度计、PROMIS-29以及研究人员开发的患者满意度项目。描述了患者特征、ePROs和转诊情况；卡方检验和t检验按患者特征检查ePRO完成情况，并按治疗方式将PROMIS-29领域与全国样本进行比较。
从2020年1月至2023年3月，315名早期LCS患者完成了生存导向访视。患者满意度较高；75%的患者完成了ePROs。总体而言，女性比男性完成ePROs的可能性更小；65岁及以上的男性、黑人或其他种族以及农村患者在诊所完成ePROs的可能性比在线完成的可能性更大。与美国早期LCS的普通人群相比，患者报告的症状负担较低；无论治疗方式如何，得分相似。中度至重度症状的发生率从6%（抑郁）到42%（身体功能差）不等；≤20%的患者有转诊安排。
一种基于转诊、由APPs配备人员的早期LCS生存诊所模式，包括使用ePROs来识别特定需求，患者可以接受。未来的工作应包括拓展女性LCS患者群体，增加支持性护理转诊以及提高接受度，以进一步满足早期LCS患者报告的需求。
