Yurdakul Ozan, Alan Abdulkarim, Krauter Johanna, Korn Stephan, Gust Kilian, Shariat Shahrokh F, Hassler Melanie R
Department of Urology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
IT Systems and Communications, Medical University of Vienna, Vienna, Austria.
Health Qual Life Outcomes. 2024 Dec 18;22(1):107. doi: 10.1186/s12955-024-02325-z.
Electronic patient-reported outcomes (ePROs) have been shown to enhance healthcare quality by improving patient symptom management or quality of life (QoL). However, ePROs data for urothelial cancer (UC) patients receiving systemic therapies are scarce, and the application of ePROs in this patient cohort may need specific setups. This study tested the feasibility of ePROs for UC patients receiving systemic therapies in the outpatient clinic of a tertiary care center.
From January 2022 to April 2023, 30 UC patients receiving systemic cancer therapies received ePROs based on the Common Terminology Criteria for Adverse Events (CTCAE) and European Organization for Research and Treatment of Cancer Core Quality of Life questionnaires (EORTC QLQ-30) to report their symptoms and QoL during systemic therapy, in total, 125 questions for every therapy cycle. The proportion of patients adherent to the ePROs was assessed to evaluate feasibility, with a preset threshold of 50%. At least half of all treatment cycles with a minimum of two consecutive ePROs (corresponding to two successive therapy cycles) had to be completed to be counted as adherent, and a maximum of six successive therapy cycles was followed by ePROs. Descriptive statistics were calculated for clinical and demographic patient characteristics. T-test and chi-square-test analyses were performed to study the association between ePROs adherence and clinical or demographic factors. The digital process was closely monitored for procedural impediments that could occur.
21 (70%) of the included 30 patients adhered to the provided ePROs, significantly higher than the predetermined threshold of 50%. Adherence remained above 70% until the end of the observation period. A significant negative effect of immigration background on ePROs compliance was observed (p = 0.006). No other variables were significantly associated with ePROs compliance.
In this study, ePROs were a feasible method to assess symptoms and QoL during the systemic cancer therapy of UC patients at our center. The compliance of patients with immigration backgrounds was the most significant barrier to using ePROs in this setting. However, the study is limited by the exclusion of patients without email access and the lack of assessment of physician compliance with the ePROs data, which may affect the generalizability and implementation of the findings.
电子患者报告结局（ePROs）已被证明可通过改善患者症状管理或生活质量（QoL）来提高医疗质量。然而，接受全身治疗的尿路上皮癌（UC）患者的ePROs数据稀缺，且ePROs在该患者群体中的应用可能需要特定设置。本研究在一家三级医疗中心的门诊测试了ePROs用于接受全身治疗的UC患者的可行性。
2022年1月至2023年4月，30例接受全身癌症治疗的UC患者基于不良事件通用术语标准（CTCAE）和欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ - 30）接受ePROs，以报告其在全身治疗期间的症状和生活质量，每个治疗周期共125个问题。评估患者对ePROs的依从比例以评估可行性，预设阈值为50%。所有治疗周期中至少一半且连续至少两个ePROs（对应两个连续治疗周期）必须完成才算依从，ePROs最多跟踪六个连续治疗周期。计算患者临床和人口统计学特征的描述性统计量。进行t检验和卡方检验分析以研究ePROs依从性与临床或人口统计学因素之间的关联。密切监测数字流程中可能出现的程序障碍。
纳入的30例患者中有21例（70%）依从所提供的ePROs，显著高于预定的50%阈值。直到观察期结束，依从率仍保持在70%以上。观察到移民背景对ePROs依从性有显著负面影响（p = 0.006）。没有其他变量与ePROs依从性显著相关。
在本研究中，ePROs是评估我们中心UC患者全身癌症治疗期间症状和生活质量的可行方法。移民背景患者的依从性是在此环境中使用ePROs的最显著障碍。然而，该研究受到排除无电子邮件访问权限患者以及缺乏对医生对ePROs数据依从性评估的限制，这可能影响研究结果的普遍性和实施。
