Brunelli Cinzia, Alfieri Sara, Zito Emanuela, Spelta Marco, Arba Laura, Lombi Linda, Caselli Luana, Caraceni Augusto, Borreani Claudia, Roli Anna, Miceli Rosalba, Tine' Gabriele, Zecca Ernesto, Platania Marco, Procopio Giuseppe, Nicolai Nicola, Battaglia Luigi, Lozza Laura, Shkodra Morena, Massa Giacomo, Loiacono Daniele, Apolone Giovanni
Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy.
Clinical Psychology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy.
JMIR Cancer. 2025 Jan 22;11:e56625. doi: 10.2196/56625.
"Patient Voices" is a software developed to promote the systematic collection of electronic patient-reported outcome measures (ePROMs) in routine oncology clinical practice.
This study aimed to assess compliance with and feasibility of the Patient Voices ePROM system and analyze patient-related barriers in an Italian comprehensive cancer center.
Consecutive patients with cancer attending 3 outpatient clinics and 3 inpatient wards were screened for eligibility (adults, native speakers, and being able to fill in the ePROMs) and enrolled in a quantitative and qualitative multimethod study. Compliance, reasons for not administering the ePROMs, patients' interaction needs, and patient-perceived System Usability Scale (range 0-100) were collected; semistructured interviews were carried out in a subsample of patients.
From June 2020 to September 2021, a total of 435 patients were screened, 421 (96.7%) were eligible, and 309 completed the ePROMs (309/421, 73.4%; 95% CI 69.8%-77.5%; mean age 63.3, SD 13.7 years). Organization problems and patient refusal were the main reasons for not administering the ePROMs (outpatients: 40/234, 17.1% and inpatients: 44/201, 21.9%). Help for tablet use was needed by 27.8% (47/169) of outpatients and 10.7% (15/140) of inpatients, while the support received for item interpretation was similar in the 2 groups (outpatients: 36/169, 21.3% and inpatients: 26/140, 18.6%). Average System Usability Scale scores indicated high usability in both groups (outpatients: mean 86.8, SD 15.8 and inpatients: mean 83.9, SD 18.8). Overall, repeated measurement compliance was 76.9% (173/225; outpatients only). Interviewed patients showed positive attitudes toward ePROMs. However, there are barriers to implementation related to the time and cognitive effort required to complete the questionnaires. There is also skepticism about the usefulness of ePROMs in interactions with health care professionals.
This study provides useful information for future ePROM implementation strategies, aimed at effectively supporting the routine clinical management and care of patients with cancer. In addition, these findings may be relevant to other organizations willing to systematically collect PROMs or ePROMs in their clinical routines.
ClinicalTrials.gov NCT03968718; https://clinicaltrials.gov/study/NCT03968718.
“患者之声”是一款为促进在肿瘤学常规临床实践中系统收集电子患者报告结局指标（ePROMs）而开发的软件。
本研究旨在评估意大利一家综合癌症中心对“患者之声”ePROM系统的依从性和可行性，并分析与患者相关的障碍。
对连续就诊于3个门诊科室和3个住院病房的癌症患者进行资格筛查（成年人、母语为意大利语且能够填写ePROMs），并纳入一项定量和定性的多方法研究。收集依从性、未实施ePROMs的原因、患者的交互需求以及患者感知的系统可用性量表（范围为0 - 100）；对部分患者进行半结构化访谈。
2020年6月至2021年9月，共筛查435例患者，421例（96.7%）符合条件，309例完成了ePROMs（309/421，73.4%；95%置信区间69.8% - 77.5%；平均年龄63.3岁，标准差13.7岁）。组织问题和患者拒绝是未实施ePROMs的主要原因（门诊患者：40/234，17.1%；住院患者：44/201，21.9%）。27.8%（47/169）的门诊患者和10.7%（15/140）的住院患者需要平板电脑使用方面的帮助，而两组在项目解读方面获得的支持相似（门诊患者：36/169，21.3%；住院患者：26/140，18.6%）。系统可用性量表平均得分表明两组的可用性都很高（门诊患者：平均86.8，标准差15.8；住院患者：平均83.9，标准差18.8）。总体而言，重复测量的依从性为76.9%（173/225；仅针对门诊患者）。接受访谈的患者对ePROMs持积极态度。然而，在实施过程中存在与完成问卷所需时间和认知努力相关的障碍。患者对ePROMs在与医护人员互动中的有用性也存在怀疑。
本研究为未来ePROM实施策略提供了有用信息，旨在有效支持癌症患者的常规临床管理和护理。此外，这些发现可能与其他希望在其临床常规中系统收集PROMs或ePROMs的组织相关。
ClinicalTrials.gov NCT03968718；https://clinicaltrials.gov/study/NCT03968718
