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将电子患者报告结局指标(ePROMs)纳入放疗后患者的个性化随访。一项可行性研究。

Integrating Electronic Patient-Reported Outcome Measures (ePROMs) into Personalised Follow-up for Patients after Radiotherapy. A Feasibility Study.

作者信息

Nuamek Thitikorn, Kwateng Peggy Adwoa Nuamah, Payne Amelia, Abdulwahid Danya, Barker Claire, Banfill Kathryn, Bayman Neil, Bowen Jones Sarah, Chan Clara, Gurumurthy Gerard, Harris Margaret, Horne Ashley, King Jennifer, Pemberton Laura, Sheikh Hamid Younus, Thomson David, Woolf David, Yorke Janelle, Price James, Faivre-Finn Corinne

机构信息

Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.

Division of Cancer Sciences, The University of Manchester, Manchester, UK.

出版信息

Tech Innov Patient Support Radiat Oncol. 2025 Aug 7;35:100333. doi: 10.1016/j.tipsro.2025.100333. eCollection 2025 Sep.

Abstract

BACKGROUND

There is an unmet need in patient monitoring between the end of radiotherapy and the first follow-up appointment during which patients may experience severe side effects. Personalised follow-up has the potential to tailor healthcare to individual needs. ePROMs enable remote monitoring and identification of those needing earlier intervention.

PURPOSE

To assess the feasibility of integrating ePROMs into personalised follow-up of patients after radiotherapy.

MATERIALS AND METHODS

Patients with lung or head and neck (HN) cancer were enrolled. ePROMs questionnaires, comprising EQ-5D-5L and 14 lung or 19 HN cancer-specific questions adapted from CTCAE v5.0, were sent to patients at eight timepoints: pre-radiotherapy, mid-radiotherapy, end of radiotherapy, weekly for four weeks post-treatment, and first face-to-face follow-up appointment. Upon completion, automated advice was provided based on responses. Grade 2 or above symptoms were escalated to clinicians. Patient feedback was obtained through structured interviews.

RESULTS

Over two months, 19 eligible patients (10 lung, 9 HN) were recruited: 13 received concurrent chemoradiotherapy, and six received radiotherapy alone. ePROMs completion rate was 69.1%, ranging from 47.4% to 89.5% at each timepoint. Three patients reported grade 3 or above symptoms on 5 instances during and after radiotherapy. Fourteen patients participated in the interviews: all 14 reported ePROMs were easy to complete, took an acceptable amount of time, and made them feel better supported.

CONCLUSION

Integrating ePROMs into personalised follow-up is feasible and acceptable to patients. ePROMs provide insights into patients' symptoms during and after radiotherapy, highlighting the need for a tailored approach.

摘要

背景

在放疗结束至首次随访预约期间的患者监测方面存在未满足的需求,在此期间患者可能会出现严重的副作用。个性化随访有潜力根据个体需求定制医疗保健服务。电子患者报告结局测量(ePROMs)能够实现远程监测并识别那些需要早期干预的患者。

目的

评估将ePROMs整合到放疗后患者个性化随访中的可行性。

材料与方法

招募肺癌或头颈部(HN)癌患者。ePROMs问卷包括EQ-5D-5L以及从CTCAE v5.0改编而来的14个肺癌或19个HN癌特异性问题,在八个时间点发送给患者:放疗前、放疗中期﹑放疗结束时、治疗后四周每周一次,以及首次面对面随访预约时。问卷完成后,根据回答提供自动建议。2级或以上症状会上报给临床医生。通过结构化访谈获得患者反馈。

结果

在两个多月的时间里,招募了19名符合条件的患者(10名肺癌患者,9名HN癌患者):13名接受同步放化疗,6名仅接受放疗。ePROMs完成率为69.1%,每个时间点的完成率在47.4%至89.5%之间。三名患者在放疗期间及放疗后有5次报告了3级或以上症状。14名患者参与了访谈:所有14名患者均报告ePROMs易于完成,耗时可接受,并且让他们感觉得到了更好的支持。

结论

将ePROMs整合到个性化随访中对患者来说是可行且可接受的。ePROMs提供了放疗期间及放疗后患者症状的相关信息,凸显了采用个性化方法的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dc4/12365331/41792fb5b1bc/gr1.jpg

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