Using PROMs to guide patients and practitioners through the head and neck cancer journey

Abstract

The measurement of patient-reported outcome measures (PROMs) following head and neck cancer (HNC) has the capacity to substantially enhance the care of patients and their care-givers following the diagnosis and treatment of HNC. Literature concerning PROMs has increased exponentially in the past 2 decades, producing a vast array of data upon which the multidisciplinary team can reflect. For this review, “Handle On QOL” has been used as a source of references to illustrate the points raised. PROMs are contextualized by considering the clinically-distinct key stages that cancer patients endure: diagnosis, treatment, acute toxicity, early recovery, late effects, recurrence, and palliation. The PROMs are considered in six main categories: 1) those addressing cornucopia of issues not specific to cancer; 2) those addressing issues common to all cancers; 3) questionnaires with items specific to HNC; 4) questionnaires that focus on a particular aspect of head and neck function; 5) those measuring psychological concerns, such as depression, anxiety, or self-esteem; and 6) item prompt lists. Potential benefits of PROMs in clinical practice are discussed, as are barriers to use. The way forward in integrating PROMs into routine HNC care is discussed with an emphasis on information technology.

Concurrent palliative care in the surgical management of head and neck cancer

“…Recent growth in the measurement of patient‐reported outcome measures has produced a wide range of data across domains beginning with diagnosis and covering outcomes specific to treatment, acute toxicity, early recovery, late effects, and palliation. The information solicited similarly ranges from general health‐related quality of life to issues specific to head and neck cancer or function . The value of patient‐reported outcomes has moved beyond just research to play a fundamental role in providing desired and valued information, enhancing communication, and achieving the best possible individualized outcomes.…”

Patients' and Clinicians' Perceptions of Clinician-Expressed Empathy in Advanced Cancer Consultations and Associations with Patient Outcomes

“…Question prompt lists (QPL) to facilitate question-asking behavior of patients and patient-reported outcome measures (PROMs) to facilitate better insight into patients' well-being and needs have turned out to be effective in improving clinician-patient communication in oncology, leading to favorable patient outcomes. [52][53][54][55] QPLs and PROMs designed to encourage patients to express their perceptions, needs, and preferences regarding their doctors' empathic communication might increase clinicians' awareness as to how they are perceived and how they could optimize their use of empathy. Future research could focus on the possibility of designing a tool to help elicit emotional needs of patients with focus on clinicians' empathy use in advanced cancer consultations and investigate its potential to improve patient-perceived empathy and ultimately patient outcomes.…”

The importance of patient-reported outcomes in cancer studies

“…Despite indications of the continuing utility of PROs in cancer, particularly within some specific cancer sites [73][74][75][76] , there are some limitations pertaining to the measures themselves and their use in practice. These include their content validity 77 and sensitivity to domains relevant to patients and those living with and beyond cancer 78 ; and potential barriers to their delivery and implementation such as length and complexity of measures or burden on well and unwell patients 79 .…”