MyChristie-MyHealth: introducing electronic patient reported outcome measures (ePROMs) in routine practice to revolutionise cancer care

Khalil, Nadia; Rust, Paul; Thomson, David P.; Smith, Eleanor; Howell, Stephen L.; Price, J; Fenemore, Jackie; Neal, H.; Halkyard, Emma; Barker-Hewitt, Matthew; Payne, Anthony M. M.; Sykes, S.; Dale, W. Andrew; Bristow, R.; Yorke, Janelle; Faivre-Finn, Corinne

doi:10.1016/s0169-5002(20)30230-0

Cited by 5 publications

(4 citation statements)

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“…Previously, clinicians have reported that they would find an ePROMs solution easy to use and useful [43], as seen in this study. In this study, clinicians expressed worries around additional time, workload, and challenges around data integration with existing IT systems, also seen previously [13,18,43,44]. Perceived benefits highlighted in this study, such as being able to identify specific symptoms, side effects, and supportive care needs of patients, have also been reported elsewhere [43].…”

Section: Comparison With Other Worksupporting

confidence: 61%

“…PROMs can also assist in identifying patients' supportive care needs and provide an opportunity to address sensitive issues or unexpected concerns [6,11,14,15]. Building on broader technological advancements, there is an increasing focus on and support for using digital tools to capture electronic PROMS (ePROMs) and their integration into routine clinical cancer care systems [9,[16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Involving Patients and Clinicians in the Design of Wireframes for Cancer Medicines Electronic Patient Reported Outcome Measures in Clinical Care: Mixed Methods Study

Dunlop,

Ferguson,

Mueller

et al. 2023

JMIR Form Res

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Background Cancer treatment is a key component of health care systems, and the increasing number of cancer medicines is expanding the treatment landscape. However, evidence of the impact on patients has been focused more on chemotherapy toxicity and symptom control and less on the effect of cancer medicines more broadly on patients’ lives. Evolving electronic patient-reported outcome measures (ePROMs) presents the opportunity to secure early engagement of patients and clinicians in shaping the collection of quality-of-life metrics and presenting these data to better support the patient-clinician decision-making process. Objective The aim of this study was to obtain initial feedback from patients and clinicians on the wireframes of a digital solution (patient app and clinician dashboard) for the collection and use of cancer medicines ePROMs. Methods We adopted a 2-stage, mixed methods approach. Stage 1 (March to June 2019) consisted of interviews and focus groups with cancer clinicians and patients with cancer to explore the face validity of the wireframes, informed by the technology acceptance model constructs (perceived ease of use, perceived usefulness, and behavioral intention to use). In stage 2 (October 2019 to February 2020), the revised wireframes were assessed through web-based, adapted technology acceptance model questionnaires. Qualitative data (stage 1) underwent a framework analysis, and descriptive statistics were performed on quantitative data (stage 2). Clinicians and patients with cancer were recruited from NHS Greater Glasgow & Clyde, the largest health board in Scotland. Results A total of 14 clinicians and 19 patients participated in a combination of stage 1 interviews and focus groups. Clinicians and patients indicated that the wireframes of a patient app and clinician dashboard for the collection of cancer medicines ePROMs would be easy to use and could focus discussions, and they would be receptive to using such tools in the future. In stage 1, clinicians raised the potential impact on workload, and both groups identified the need for adequate IT skills to use each technology. Changes to the wireframes were made, and in stage 2, clinicians (n=8) and patients (n=16) indicated it was “quite likely” that the technologies would be easy to use and they would be “quite likely” to use them in the future. Notably, clinicians indicated that they would use the dashboard to enable treatment decisions “with around half” of their patients. Conclusions This study emphasizes the importance of consulting both patients and clinicians in the design of digital solutions. The wireframes were perceived positively by patients and clinicians who were willing to use such technologies if available in the future as part of routine care. However, challenges were raised, and some differences were identified between participant groups, which warrant further research.

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Section: Comparison With Other Worksupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Involving Patients and Clinicians in the Design of Wireframes for Cancer Medicines Electronic Patient Reported Outcome Measures in Clinical Care: Mixed Methods Study

Dunlop,

Ferguson,

Mueller

et al. 2023

JMIR Form Res

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“…Independently of this, patients are also asked to complete an ePROM questionnaire before the appointment via an email or text message (at this first appointment and all subsequent visits), which is optional but if completed provides self-reported smoking status data. The ePROMS platform has been operational since January 2019 and uses electronic questionnaires that include symptombased questions (developed using the Common Terminology Criteria for Adverse Events Version 5.0 and patient and clinician feedback) and QoL questions (EQ-5D-5L) [17]. Patients are asked to 'Please select the statement about smoking most applicable to you' by answering with 'current smoker', 'ex-smoker' or 'I have never smoked'.…”

Section: Methodsmentioning

confidence: 99%

The Role of Electronic Patient-Reported Outcome Measures in Assessing Smoking Status and Cessation for Patients with Lung Cancer

et al. 2022

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Introduction: Smoking cessation following lung cancer diagnosis is recommended to improve patient outcomes. Electronic Patient Reported Outcome Measures (ePROMs) may be useful for identifying and facilitating cessation support in patients that continue to smoke after a cancer diagnosis. The primary aim was to investigate the level of agreement between clinician-reported and self-reported patient smoking status during the first visit to a cancer centre (I). Secondary aims included investigating differences between cancer-specific characteristics between never smokers and current/exsmokers (IIA), and the self-reported frequency of smoking cessation after diagnosis of lung cancer (IIB). Methods: Retrospective single-centre study carried out at a tertiary cancer centre in the UK. Lung cancer patients that completed at least one ePROM questionnaire within 6 weeks of their first visit to the cancer centre (baseline), between February 2019 and February 2020, were included in the study. All ePROM questionnaires included a question regarding smoking status to allow comparison with the clinician records. Patients were offered these electronic questionnaires at each subsequent visit to the hospital. Results: Of 195 patients included, 24 (12.3%) demonstrated discordance between clinician-

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“…In some cases, this was due to the physician’s reluctance to use the International Consortium for Health Outcomes Measurement rule sets [ 37 ]. In addition, the history of some employees with previous attempts to implement and collect ePROMs created barriers to the success of this measurement [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Improving the Understanding and Managing of the Quality of Life of Patients With Lung Cancer With Electronic Patient-Reported Outcome Measures: Scoping Review

Abejas¹,

Trullas²,

Sobral³

et al. 2023

J Med Internet Res

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Background Electronic patient-reported outcome measures (ePROMs) are essential to clinical practice and research. The growth of eHealth technologies has provided unprecedented opportunities to collect information systematically through ePROMs. Although they are widely used in scientific research, more evidence is needed to determine their use and implementation in daily clinical practice. For example, when diagnosed, patients with lung cancer are at an advanced stage of the disease. This entails tremendous burden because of high mortality and losses in the different dimensions of the human being. In this case, monitoring symptoms and other outcomes help improve the patient’s quality of life. Objective ePROMs offered unprecedented opportunities to collect information systematically. Our goal was to demonstrate that ePROMs are more useful in controlling patient symptoms, lung cancer, and overall survival than their alternatives, such as nonelectronic PROMs. Methods This exploratory review considered articles published between 2017 and 2022 identified through searches of PubMed, Scopus, Cochrane, CINAHL, and PsycINFO. We found 5097 articles; after removing the duplicates, we reduced them to 3315. After reading the summary, we were left with 56. Finally, after applying the exclusion criteria, we reviewed 12. The 5-step framework by Arksey and O’Malley was used to refine the initial search results with the following research questions: Do ePROMs help physician-patient communication? To what extent do they improve decision-making? Are institutions and their digitization policies barriers to or facilitators of this process? and What else is needed for routine implementation? Results This review included 12 articles. We found that ePROMs are an integrative and facilitative communication tool, highlighting their importance in the relationship between palliative care and medical oncology. ePROMs help assess patient symptoms and functionality more accurately and facilitate clinical decision-making. In addition, it allows for more precise predictions of overall patient survival and the adverse effects of their treatments. The main institutional obstacles are the initial investment, which can be costly, and the data protection policy. However, enablers included better funding through the development of telemedicine, support from institutional leaders to overcome resistance to change, and transparent policies to ensure the safe and secure use of ePROMs. Conclusions Routine collection of remote ePROMs is an effective and valuable strategy for providing real-time clinical feedback. In addition, it provides satisfaction to patients and professionals. Optimizing ePROMs in patients with lung cancer leads to a more accurate view of health outcomes and ensures quality patient follow-up. It also allows us to stratify patients based on their morbidity, creating specific follow-ups for their needs. However, data privacy and security are concerns when using ePROMs to ensure compliance with local entities. At least four barriers were identified: cost, complex programming within health systems, safety, and social and health literacy.

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MyChristie-MyHealth: introducing electronic patient reported outcome measures (ePROMs) in routine practice to revolutionise cancer care

Cited by 5 publications

References 0 publications

Involving Patients and Clinicians in the Design of Wireframes for Cancer Medicines Electronic Patient Reported Outcome Measures in Clinical Care: Mixed Methods Study

Involving Patients and Clinicians in the Design of Wireframes for Cancer Medicines Electronic Patient Reported Outcome Measures in Clinical Care: Mixed Methods Study

The Role of Electronic Patient-Reported Outcome Measures in Assessing Smoking Status and Cessation for Patients with Lung Cancer

Improving the Understanding and Managing of the Quality of Life of Patients With Lung Cancer With Electronic Patient-Reported Outcome Measures: Scoping Review

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