Changes in Patient-Reported Health Status in Advanced Cancer Patients from a Symptom Management Clinic: A Longitudinal Study Conducted in China

Abstract

Objectives. e integration of patient-reported health status has been increasingly emphasised for delivering high-quality care to advanced cancer patients. is research is designed to track health status changes over time in Chinese advanced cancer patients to explore the risk factors a ecting their health status. Methods. Advanced cancer patients were recruited from Peking University Cancer Hospital. An electronic patient-reported outcome (ePRO) system with validated measurements was used to collect the data. ANOVA, the chi-square test, the nonparametric Kruskal-Wallis H test, and generalized estimating equation (GEE) analysis were used for the data analysis. Results. One hundred and three patients completed a baseline survey (T = 0) and two follow-up surveys (T1 = 14 days, T2 = 28 days). Chi-square test results indicate a signi cant decrease in the percentage of patients reporting moderate or severe di culty experienced by patients in terms of mobility, pain/discomfort, and anxiety/depression. However, there is a signi cant increase in the percentage of patients reporting moderate or severe di culty in self-care and usual activities. Scores on the visual analogue scale in the EQ-5D-5L instrument (EQ-VAS) are associated with patients' income, and the degree of moderate or severe anxiety/depression is found to be associated with employment status. e GEE results show that pain, loss of appetite, poor walking status e ected by symptoms, depression, and anxiety has worsened the health status. Conclusions. e health status of Chinese advanced cancer patients under ePRO follow-up in China signi cantly improves in the physical and psychological dimensions, accompanied by a decrease in usual activities and self-care. Routine screening and rational supportive care are recommended in oncology for cancer care. Based on the rational application of ePRO, longitudinal studies exploring the potential mechanisms of health status changing would provide more bene cial guidance for improving the quality of life in patients with advanced cancer.

The advantages, disadvantages, threats, and opportunities of electronic patient-reported outcome systems in cancer: A systematic review

“…“Small sample size” was the most frequently mentioned challenge. 1 , 17 , 33 , 34 , 38 , 47 , 54 , 56 , 58 , 63 , 65 , 70 , 72 , 74 , 83 , 85 , 87 , 90 , 91 This finding aligned with broader challenges in research methodologies and emphasized the need for innovative approaches to surmount limitations and enhance generalizability. Doolin et al implemented ePRO for patients with new oral chemotherapy prescriptions at both an academic site and a community site.…”

“…On the other hand, the review also identified several disadvantages associated with electronic Patient Reported Outcome Measures (ePROMs). The most prevalent disadvantage was “Small sample size,” cited in 19 studies (15.70%), reflecting a common challenge in research methodologies that may limit the generalizability of findings, 1 , 17 , 33 , 34 , 38 , 47 , 54 , 56 , 58 , 63 , 65 , 70 , 72 , 74 , 83 , 85 , 87 , 90 , 91 followed by “Technical issues” with 16 references (13.22%), highlighting the challenges posed by technology in the implementation of electronic health platforms 18 , 19 , 24 , 34 , 39 , 47 , 50 , 60 , 66 – 68 , 74 , 76 , 81 , 92 , 93 and “Potential bias” with 12 references (9.92%), emphasizing the need for researchers to address and mitigate bias in participant selection, data extraction and reporting. 16 , 22 , 40 , 41 , 43 , 57 , 65 , 74 , 84 ,…”

“…In terms of threats, the review identified “Challenges in data security and technical skills” as the most prevalent threat, cited in 21 studies, (42.00%) reflecting the growing concern around data security and the importance of technical expertise in managing electronic health platforms, 18 , 19 , 24 , 34 , 39 , 47 , 50 , 60 , 66 – 68 , 71 , 74 , 76 , 81 , 84 , 92 , 93 , 96 followed by “Integration Challenges” with nine references (18.00%), indicating the complexities associated with seamlessly integrating these platforms into existing healthcare systems. 25 , 39 , 52 , 59 , 83 , 84 , 93 , 97 , 98 and “Potential Resource, Administrative Challenges and Resource Constraints” with six references, (12.00%) indicating the complexities associated with seamlessly integrating these platforms into existing healthcare systems.…”

“…Finally, the review also highlighted various opportunities associated with ePROMs. The most prevalent opportunity was “Addressing data security and technical skills concerns,” cited in 20 studies (18.02%), indicating the recognition of these concerns as potential areas for improvement and advancement, 18 , 19 , 24 , 34 , 39 , 47 , 50 , 60 , 66 – 68 , 71 , 74 , 76 , 81 , 92 , 93 , 96 followed by “Opportunities for symptom management, monitoring and detection” with 19 references (17.12%), emphasizing the potential for technological advancements to enhance symptom management and monitoring, 39 , 44 , 49 , 51 , 70 , 75 – 77 , 80 , 81 , 84 , 86 – 89 , 98 – 101 and “Improved communication” with 11 references (9.91%), reflecting the recognition of enhanced communication as a valuable opportunity for better patient outcomes. 18 , 24 , 25 , 32 , 44 , 51 , 59 , 79 , …”

“…“Real-time and Remote Monitoring,” emerges as another salient advantage. 1 , 16 – 18 , 31 , 33 , 34 , 36 – 39 , 43 , 44 , 47 , 49 – 51 , 54 , 56 , 57 , 59 , 60 , 63 , 64 , 66 , 70 , 72 – 83 emerged as a crucial aspect in our exploration of ePRO systems. This aligned with our overarching objective of examining the broader applications of ePRO systems.…”