291 Background: St Mary’s Hospital, an affiliated McGill Teaching University Hospital, receives ~700 new cancer patients yearly. In 2014-17, electronic PROs were implemented through the Improving Patient Experience and Health in Outcomes Collaborative in partnership with Cancer Care Ontario, granted by Canadian Partnership against Cancer and Rossy Cancer Network, as part of a PRO Canadian Initiative to improve the Patient Experience across Canada through standardized measurement of health-related outcomes for patients. Methods: The PROs measures included the Edmonton Symptom Assessment Scale (ESAS), additional measures for Fatigue, Anxiety, Depression, and Pain, the Social Difficulties Inventory-21 and Quality of Life. PRO-data was scored in real-time; nurses and patients received a printed summary report. Nurses were provided with an algorithm and instructions. Monthly Distress Screening Dashboard were generated with key indicators. In 2016, all patients receiving chemotherapy were assessed at each cycle of treatment. After project completion, due to nursing staff shortage, the frequency of screenings was reduced. Yearly Dashboard results were used to promote discussion with clinicians and address sustainability constraints of PROs in real-word oncology practice. Results: In 2016 1366 total screens completed ( 376 patients) and in 2018, 753 total screens (325 patients). This comparison indicates that a decrease in frequency of screenings resulted in an increase in symptom severity in all health-related outcomes. Physicians’ participation was proposed as mitigation plan to increase screening frequency. We propose to present a three year retrospectively cross analyzed patient data to examine symptom change over time, frequencies of screening, impact on patients’ health outcomes, overlapping sustainability constraints encountered and mitigation plans. Conclusions: Embedding the use of PRO into existing hospital structures requires constant review involving administrative, clinician and patient engagement.

Background: St Mary’s Hospital is an affiliated McGill Teaching University Hospital in Montreal, receiving ~700 new cancer patients yearly. In 2008, the oncology department implemented Patient Reported Outcomes (PROs) on paper. In 2014-17, electronic PROs were implemented through the Improving Patient Experience and Health in Outcomes Collaborative (iPEHOC) Implementation Project, as part of a PRO Canadian Initiative to improve the Patient Experience across the cancer journey through standardized measurement that accelerates optimal care and measures impact (health-related outcomes for patients) across Canada. Methodology: The PROs measures included the Edmonton Symptom Assessment Scale (ESASr), four additional secondary PROMs for Fatigue, Anxiety, Depression, and Pain, the Social Difficulties Inventory-21 and a single item Quality of Life. PRO data was scored in real-time; nurses and patients received a printed summary report. Nurses were provided with an algorithm (Global Response to Distress) and follow-up instructions. Monthly Distress Screening Dashboard ware generated with number of screenings, number of patients screened, symptom prevalence, secondary PROMs trigger rates, Social Difficulties triggered and clinically significant symptoms changes on the four secondary PROMs. In 2016, all patients receiving chemotherapy were assessed at each cycle of treatment (screening). After project completion, due to nursing staff shortage, the frequency of screenings was reduced and offered at pre-established time-points (assessment). Yearly Dashboard results were used to promote a discussion with clinicians and address sustainability constraints of PROs in real-word oncology practice. Results: In 2016, a total of 366 patients were screened, resulting in 1366 annual screens. In 2018, 325 patients were screened resulting in 753 annual screens. This change in practice, that culminated organically, allows for an observation analysis between screening versus assessment. Noteworthy comparison between 2018 and 2016 showed that the decrease in frequency of screenings resulted in significant increase in symptom severity in all health-related outcomes. Breast cancer represented 35% of all screens completed. We propose to present a three year retrospectively cross analyzed patient data to examine symptom change over time, frequencies of screening, the impact on patients’ health outcomes, the overlapping sustainability constraints encountered and mitigation plans. Discussion: Embedding the use of PRO into existing hospital structures requires constant review involving administrative, clinician and patient engagement. PRO data can be used to better identify the needs of a specific cancer type population and create tailored care paths. Citation Format: Ashley Kushneryk, Rosana Faria. Real-word implementation of patient report outcomes: Sustainability constraints and impact on patients health outcomes [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-17.

Leriche syndrome typical signs include incapability for erection maintaining, fatigue feeling originating from both lower limbs, bilateral claudication with ischemic pain and lack or reduction of peripheral pulse (starting from femoral segment) combined with paleness or coldness of both lower limbs. The disease commonly affects men, and risk factors include hypertension, diabetes mellitus, hyperlipidemia and smoking. Currently the disorder is referred to type D aortoiliac injuries according to Trans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Data on psychiatric morbidity in Leriche syndrome is scarce. Some publications are dedicated in such a state to depressive disorder and erectile dysfunction, which were observed in psychiatric outpatient department. These may have several reasons, such as obesity, hypertension, diabetes mellitus, hypercholesterolemia and lower urinary tract symptoms. Moreover, erectile dysfunction is believed to be a strong predictor of general and coronary atherosclerosis. Leriche syndrome and penis arteries obstructive disease are considered to be two main reasons of impotence. Other reasons of Leriche syndrome may be lifestyle factors which are common with atherosclerosis: insufficient physical exercises, imbalanced diet and smoking. Statistics on psychiatric morbidity in Leriche syndrome is hard to receive because of multiple risk factors, partially because of atherosclerosis, which is the risk for vascular depression. The article represents historical data about prominent doctors in the history of vascular surgery who touched upon the problems of Leriche syndrome. The authors describe their own clinical observations of acute patient with prolonged development of full clinical manifestation with fatal outcome.

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