Clinician perspectives on symptom and quality of life experiences of patients during cancer therapies: Implications for eHealth

Abstract

Objective The purpose of this study was to explore clinician experiences with cancer symptom and quality of life (SQL) management from diagnosis throughout therapy in the ambulatory setting, plus identify preferences for a future SQL decision support system. Methods Eligible clinicians worked in ambulatory cancer care with responsibility for direct patient care. Focus groups were conducted to discuss symptom management throughout the treatment experience and features desired in a future decision support system. Each group was audio‐recorded, transcribed, de‐identified, and entered into NVivo 9 for analysis. Open and axial coding was completed, grouping common concepts into nodes; large constructs among the nodes were identified and main messages were synthesized. Results A total of 118 clinicians were contacted by email resulting in a final sample of 51 attending 1 of 9 focus groups. Clinicians described a standard face‐to‐face approach to assessment of SQL, before and throughout therapy. Preparing patients for expected symptoms and approaches to management included paper‐based patient education materials and referrals. Communicating with patients between visits was covered in detail, notably use of telephone and email. Future system features desired by the clinicians included an electronic, Web‐based system with real‐time, trended data, reasonable alerts, and tailored information for patients. Conclusions Cancer care specialists reported strategies to assess and manage cancer SQL in ambulatory care including patient‐reported outcome measures, contact communication modes, face‐to‐face interviews, and paper‐based patient education materials. Future system features desired by clinicians included an electronic, Web‐based system with real‐time, trended data, reasonable alerts, and tailored information for patients.

A real-time electronic symptom monitoring system for patients after discharge following surgery: a pilot study in cancer-related surgery

“…The nature and severity of symptoms experienced by patients was also not measured. The functionality to provide individually-tailored advice based on symptom severity has been identified as particularly important for the effectiveness of ePRO systems [46][47][48]. Similarly, the incorporation of clinician alerts to ePRO systems can increase clinician involvement in patient care and improve patient outcomes [25,29].…”

Oncologists' Perceptions of a Digital Tool to Improve Cancer Survivors' Cardiovascular Health

“…The importance of this type of data synthesis mirrors work by Berry and colleagues, while investigating clinicians' perspectives of an e-health tool addressing symptoms and quality of life during cancer therapy. 65 The importance of interface functionality identified by the oncologists in this study, including ease of use and user-centered tailoring, is supported by the work of Puszkiewicz and colleagues 66 and Robertson and colleagues. 67 In both studies, researchers identified the importance of goals coming from a trusted source and the importance of data visualization.…”

Applying M-Health to Palliative Care: A Systematic Review on the Use of M-Health in Monitoring Patients With Chronic Diseases and its Transposition in Palliative Care

“…The health professionals seem to wish for the development of an electronic monitoring in real time for symptom management. 60…”

“…The health professionals seem to wish for the development of an electronic monitoring in real time for symptom management. 60 However, it seems important to keep in mind that the implementation of such a tool should not be done to the detriment of the founding principles of palliative care. It is important to avoid the pitfalls of standardized care with the use of an app on the pretext of being more efficient.…”

“…22 This direct contact could then be assured with telemedicine, allowing a more detailed evaluation of the episode and possibly avoid the recourse to emergency services and allow better symptom control. 60 The recourse of telemedicine also seems to reduce the "feeling of burden" felt by the natural caregiver. 61 Place of medicine intake monitoring.…”