Implementing electronic patient-reported outcomes for patients with new oral chemotherapy prescriptions at an academic site and a community site
Abstract
PURPOSE: Oral chemotherapy challenges providers' abilities to safely monitor patients' symptoms, adherence, and financial toxicity. COVID-19 has increased the urgency of caring for patients remotely. Collection of electronic patient-reported outcomes (ePROs) has demonstrated efficacy for patients on intravenous chemotherapy, but limited data support their use in oral chemotherapy. We undertook a pilot project to assess the feasibility of implementing an ePRO system for patients starting oral chemotherapy at our cancer center, which includes both an academic site and a community site. METHODS: Patients initiating oral chemotherapy were asked to participate. A five-question tool was built in REDCap. Concerning responses triggered outreach within one business day. The primary outcome was time to first symptom assessment. For comparison, we used a historical cohort of patients who had been prescribed oral chemotherapies by providers in the same disease groups at the cancer center. RESULTS: Twenty-five of 62 (40%) patients completed ePRO assessments. Fifty historical charts were reviewed. Time to first symptom assessment was 7 days (IQR, 4-14 days) in the historical group compared with 3 days (IQR, 2-4 days) in the ePRO group. Time to clinical action was 14 days (7-35 days) in the historical group compared with 8 days (4-19 days) in the ePRO group. No statistically significant differences were detected in 30-day emergency department visit or hospitalization (12% for both groups) or 90-day emergency department visit or hospitalization rates (historical 28% and ePRO 20%). CONCLUSION: An ePRO tool monitoring patient concerns about adherence, cost, and toxicities for patients with new oral chemotherapy regimens is feasible and improves time to symptom assessment. Further investigation is needed to improve patient engagement with ePROs and evaluate the long-term impacts for patients on oral chemotherapy.
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“19 – 22 A cluster, pragmatic randomized trial that included 52 U.S. community oncology practices and 1191 patients with metastatic cancer in the United States, recently revealed encouraging engagement metrics but also challenges regarding increased healthcare provider (HCP) burden.”
Background
- Authors
- Doolin, J. W., Berry, J. L., Forbath, N. S., Tocci, N. X., Dechen, T., Li, S., Hartwell, R. A., Espiritu, J. K., Roberts, D. A., Zerillo, J. A., & Shea, M.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Clovis Oncology (United States) (US)
- Dana-Farber Cancer Institute (US)
- ORCID
- Venue
- JCO Clinical Cancer Informatics
- Published
- 2021-12
- Volume
- 5
- Issue
- 5
- Pages
- 631-640
- ISSN
- 2473-4276 (ISSN-L)
- OpenAlex
- W3170619927
- Cited by
- 20
- References
- 15
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 8 · 2023: 3 · 2022: 3
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JCO Clinical Cancer Informatics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- electronic patient-reported outcomes, oral chemotherapy, symptom monitoring, medication adherence, financial toxicity, REDCap, feasibility, emergency department visits, hospitalization, patient engagement
- MeSH terms
- Patient Reported Outcome Measures, Administration, Oral, Aged, Antineoplastic Agents, Female, Humans, Male, Middle Aged, Pilot Projects, Surveys and Questionnaires, Internet, Electronic Health Records
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