Patient-reported outcome measurement implementation in cancer survivors: a systematic review

Abstract

Patient reported outcome measurements (PROMs) are increasingly used for cancer patients receiving active treatment, but little is known about the implementation and usefulness of PROMs in cancer survivorship care. This systematic review evaluates how cancer survivors and healthcare providers (HCPs) perceive PROM implementation in survivorship care, and how PROM implementation impacts cancer survivors' health outcomes. Methods: We systematically searched PubMed/MEDLINE, Embase, CINAHL, Web of Science, and Cochrane Database of Systematic Reviews from database inception to February 2022 to identify randomized and nonrandomized studies of PROM implementation in cancer survivors.Results: Based on prespecified eligibility criteria, we included 29 studies that reported on 26 unique PROMs. The studies were heterogeneous in study design, PROM instrument, patient demographics, and outcomes. Several studies found that cancer survivors and HCPs had favorable impressions of the utility of PROMs, and a few studies demonstrated that PROM implementation led to improvements in patient quality of life (QoL), with small to moderate effect sizes. Conclusions:We found implementation of PROMs in cancer survivorship care improved health outcomes for select patient populations. Future research is needed to assess the real-world utility of PROM integration into clinical workflows and the impact of PROMs on measurable health outcomes.

Real time patient‐reported outcome measures in patients with cancer: Early experience within an integrated health system

“…PROMs are delivered through a variety of methods, both on paper and digitalelectronically. 6 Use of remote completion in this study demonstrate a digital division within our population. White, younger, female, and married patients and those with in situ disease or living in higher socioeconomic status areas were more likely to have completed PROMs prior to their visit using the patient portal.…”

“… 20 While implementation of PROMs has been successful within disease‐specific clinics, this manuscript describes a program that is rather unique in the breadth of implementation (i.e., throughout the cancer enterprise). 6 , 21 , 22 Strategies for success were engagement of multidisciplinary providers representing a wide breadth of clinical disease sites at the onset of the process, strong support from the cancer leadership, and focusing on implementation of domain, rather than disease‐site specific instruments. In addition to stakeholders, a physician champion was identified for each clinical unit.…”

“…These PROMs have been developed and validated to measure function and symptoms in both the general population and those with chronic conditions including cancer. 1 , 2 , 3 , 4 , 5 , 6 These domains were selected based on consensus from the Committee as they are impacted by cancer diagnosis and treatments for the vast majority of cancer types and stages; they can also help to facilitate clinical care and appropriate referrals. These domains were also recommended by HealthMeasures—“the dissemination and implementation hub for … PROMIS … originally funded by the National Institutes of Health” as the key domains for cancer care.…”

“…In patients where PROMs were used, 1‐year overall and quality‐adjusted survival were also improved 4 . In addition, PROMs have been demonstrated to be essential in the assessment of symptoms in multiple clinical trials 2,5–8 . Therefore, PROMs are potentially very powerful tools that can affect a threshold change in quality of cancer care.…”

“… 4 In addition, PROMs have been demonstrated to be essential in the assessment of symptoms in multiple clinical trials. 2 , 5 , 6 , 7 , 8 Therefore, PROMs are potentially very powerful tools that can affect a threshold change in quality of cancer care. However, implementation of PROMs is often limited to clinical trial settings.…”