1748 Electronic Patient Reported Outcome Measures – Next Generation Cancer Patient Monitoring?

Abstract

Background Electronic Patient Reported Outcome Measures (ePROMs) are validated, digitalised health questionnaires with roots in clinical trials, created as a way of re-establishing and empowering the patient voice. ePROMs are now utilised in over 30 different medical specialties, and it is recognised that their unique abilities for detecting symptomology and other quality of life (QOL) issues directly from the patient make them highly suitable as an adjunct in routine clinical care. Their use, particularly in adult Oncology, has brought a number of benefits to light, however use of ePROMs in child and young adult groups remains limited. Objectives The literature review is part of a service evaluation at The Christie NHS Foundation Trust, Manchester, to better understand the benefits ePROMs bring to patients, as well as the barriers and facilitators of implementing such a service. Methods We searched PubMed for the terms: ‘Patient Reported Outcome Measure’ or ‘PROM’ or ‘PRO’ AND ‘cancer’ or ‘carcinoma’ or ‘onco*’ and selected papers relevant to the implementation of ePROM services into clinical care. There were 100 relevant titles. Results Improved communication: Improvements have been seen in the quantity and type of symptoms/QOL issues reported , better prioritisation and focussing of the consultation, shared decision-making and treatment goals, patient involvement in care, and as a facilitator of open dialogue and discussion of sensitive topics. Acceptability: Patients find ePROM services highly acceptable, tend to prefer electronic over paper questionnaires, and most patients report that ePROMs are a good way to communicate with their medical team. Symptom Detection and Management: Evidence suggests that practitioners frequently underestimate patients’ experience of symptoms. ePROMs have been shown to consistently improve symptom discussions and onward management, as well as detection of therapy-related adverse events (particularly chemotherapy) Improved Healthcare Process: Studies have shown that ePROMs can reduce A&E attendance, unplanned hospital admissions or unnecessary hospital appointments. ePROM completion has been used to tailor the follow-up of patients and also to report symptoms in real-time, enabling the acute medical team to action the outcomes as necessary. Better QOL: Several studies have demonstrated improvement in symptom scores as well as global QOL with ePROM use. Better Overall Survival: In an oncology population, it has now been shown that successful ePROM services can improve patient survival due to their unique benefits in symptom detection and management. Barriers and Facilitators to ePROM use: A number of barriers to ePROM use are discussed at the level of the patient, the practitioner and the organisation, as well as approaches to mitigate these. Conclusions Digitalised personal healthcare is the next generation in patient monitoring; ePROM services are being rolled out across a number of adult specialties but their use in child and young adult groups is limited. Here we present a multitude of benefits that ePROMs are known to have, and share some of the barriers and facilitators when considering establishing a new ePROMs service. The benefits of ePROMs should (and can) be shared by adults and children alike, and should particularly be considered in paediatric haematology and oncology populations.