Completion of Patient-Reported Outcome Questionnaires among Older Adults with Advanced Cancer

2021 ◽  
Author(s):  
Marie A. Flannery ◽  
Supriya Mohile ◽  
Eva Culakova ◽  
Sally Norton ◽  
Charles Kamen ◽  
...  
Keyword(s):  
Older Adults ◽  
Advanced Cancer ◽  
Patient Reported Outcome ◽  
Patient Reported

Standardised approach to measuring goal-based outcomes among older disabled adults: results from a multisite pilot

2020 ◽  
pp. bmjqs-2019-010742
Author(s):  
Erin R Giovannetti ◽  
Catherine A Clair ◽  
Lee A Jennings ◽  
Shana F Sandberg ◽  
Angelia Bowman ◽  
...  
Keyword(s):  
Older Adults ◽  
Goal Attainment ◽  
Health Management ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Goal Attainment Scaling ◽  
Care Needs ◽  
Trade Offs ◽  
Patient Reported ◽  
Specific Care

BackgroundOlder adults with complex care needs face trade-offs in determining the right course of treatment. The Centers for Medicare and Medicaid Services identified ‘Care is personalized and aligned with patient’s goals’ as a key meaningful measures category, yet existing quality measures typically assess disease-specific care and may not effectively evaluate what is most important to older adults and family members. Measures based on individualised goals and goal-based outcomes have been proposed as an alternative but are not routinely assessed or implemented.ObjectivesWe tested two approaches to assessing goal-based outcomes that allow individuals to set goals based on their own priorities and measure progress—(1) goal attainment scaling and (2) existing, validated patient-reported outcome measures (PROM).MethodsA prospective cohort study of feasibility in seven sites (33 clinicians) of the two approaches with 229 individuals. We calculated performance on a measure of achievement of individually identified goals.ResultsBoth approaches were successfully implemented in a non-randomly selected population, and a goal-based outcome could be calculated for 189 (82%) of participants. Most individuals met their goal-based outcome (73%) with no statistical difference between the goal attainment scaling approach (74%) and the patient-reported outcomes approach (70%). Goals were heterogeneous ranging from participating in activities, health management, independence and physical health. Clinicians chose to use goal attainment scaling (n=184, 80%) more often than PROMs (n=49, 20%) and rated the goal attainment scaling approach as useful for providing patient care.ConclusionGoal-based outcomes have the potential to both improve the way healthcare is provided and fill a critical gap in value-based payment.

Predictive value of the patient reported outcome “living with cancer” instrument on overall survival in advanced cancer patients: A tool for guiding timing of palliative care consultations.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10025-10025
Author(s):  
Stuart L. Goldberg ◽  
Dhakshila Paramanathan ◽  
Srikesh Arunajadai ◽  
Victoria DeVincenzo ◽  
Ruth Pe Benito ◽  
...  
Keyword(s):  
Palliative Care ◽  
Overall Survival ◽  
Advanced Cancer ◽  
Cox Model ◽  
Performance Status ◽  
Patient Reported Outcome ◽  
Cancer Type ◽  
Advanced Cancer Patients ◽  
Patient Reported ◽  
Living With Cancer

10025 Background: The Living with Cancer (LWC) patient reported outcome (PRO) instrument evaluates distress from the point of view of the advanced cancer pt. The 7-item Likert survey measures 4 personhood domains (performance status, pain, burden [financial and family], depression) with scores ranging 0-112. In a pilot study of 433 cancer pts at a single center a score of >28 was associated with an increased likelihood of physician’s (blinded) opinion of need for end-of-life care discussions ( J Palliative Med 2016). Methods: The LWC instrument is a statistically validated PRO (ASCO Palliative Care Symposium 2016). LWC was administered to 1024 cancer pts receiving non-curative therapy at 7 centers (Regional Cancer Care Associates, NJ) from Sept 2015 - Oct 2016. LWC surveys were linked to the Cota database, which extracts and enriches data from EHRs. Date of survey was used as the start point in time-to-event analysis. Results: 290 (28%) pts expired during the study (median f/u 9.9 months). 267 (26%) pts exceeded the threshold score of 28 defined in the pilot set (28 was also independently this study’s optimal cut point). Pts with an LWC score >28 had inferior 6 and 12 mo overall survival (69% and 54%) vs pts with scores <29 (88% and 73%) (log rank p<0.001). A Cox model demonstrated that LWC score and cancer type were significant (LWC: p<0.001, cancer types (compared to B): GI p<0.001, GU: p=0.013, T: p<0.001, M: p=0.334) A one point score increase in LWC resulted in a 1.8% increase in expected hazard. Among solid tumor pts with LWC >28, 20% died within the next 3 mo and 35% died within the next 6 mo, indicating appropriate timing for hospice and palliative care consults, respectively. Conclusions: Pt responses to the LWC instrument predict survival among advanced cancer pts and may be useful in guiding timing of palliative care consultations. [Table: see text]

scholarly journals Robot for health data acquisition among older adults: a pilot randomised controlled cross-over trial

2019 ◽  
Vol 28 (10) ◽  
pp. 793-799 ◽  
Author(s):  
Roel Boumans ◽  
Fokke van Meulen ◽  
Koen Hindriks ◽  
Mark Neerincx ◽  
Marcel G M Olde Rikkert
Keyword(s):  
Older Adults ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Well Being ◽  
Patient Reported Outcome ◽  
Outpatient Setting ◽  
Community Dwelling ◽  
Patient Reported ◽  
Randomised Controlled ◽  
Community Dwelling Older Adults

Background /ObjectivesHealthcare professionals (HCP) are confronted with an increased demand for assessments of important health status measures, such as patient-reported outcome measurements (PROM), and the time this requires. The aim of this study was to investigate the effectiveness and acceptability of using an HCP robot assistant, and to test the hypothesis that a robot can autonomously acquire PROM data from older adults.DesignA pilot randomised controlled cross-over study where a social robot and a nurse administered three PROM questionnaires with a total of 52 questions.SettingA clinical outpatient setting with community-dwelling older adults.ParticipantsForty-two community-dwelling older adults (mean age: 77.1 years, SD: 5.7 years, 45% female).MeasurementsThe primary outcome was the task time required for robot–patient and nurse–patient interactions. Secondary outcomes were the similarity of the data and the percentage of robot interactions completed autonomously. The questionnaires resulted in two values (robot and nurse) for three indexes of frailty, well-being and resilience. The data similarity was determined by comparing these index values using Bland-Altman plots, Cohen’s kappa (κ) and intraclass correlation coefficients (ICC). Acceptability was assessed using questionnaires.ResultsThe mean robot interview duration was 16.57 min (SD=1.53 min), which was not significantly longer than the nurse interviews (14.92 min, SD=8.47 min; p=0.19). The three Bland-Altman plots showed moderate to substantial agreement between the frailty, well-being and resilience scores (κ=0.61, 0.50 and 0.45, and ICC=0.79, 0.86 and 0.66, respectively). The robot autonomously completed 39 of 42 interviews (92.8%).ConclusionSocial robots may effectively and acceptably assist HCPs by interviewing older adults.

scholarly journals EXCURSION FROM HOME AND ECOLOGICAL PAIN IN OLDER ADULTS WITH KNEE PAIN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S524-S524
Author(s):  
Mamoun T Mardini ◽  
Parisa Rashidi ◽  
Subhash Nerella ◽  
Dottington Fullwood ◽  
Duane Corbett ◽  
...  
Keyword(s):  
Older Adults ◽  
Pain Intensity ◽  
Knee Pain ◽  
Geodesic Distance ◽  
Patient Reported Outcome ◽  
Living Environment ◽  
Life Space ◽  
Patient Reported ◽  
The Impact ◽  
Daily Pain

Abstract Background: Pain is an essential factor in limiting life-space mobility. Ecological momentary assessment (EMA) is crucial to understanding pain intensity and frequency. This study evaluated a customized smartwatch app for daily ecological pain reporting and GPS (Global Positioning System) coordinates collection to understand the impact of pain on daily excursion from home in older adults who report knee pain. Methods: Participants (n=14, 73.2 +/- 5.4 yrs, 64% female) wore a smartwatch with a customized app called Patient Reported Outcome of Mood, Pain, and fatigue (PROMPT) for 6.5 (4.0) days. Participants were prompted in their free-living environment about their pain intensity (range 0-10) in the morning, afternoon and evening. Additionally, GPS data were collected at 15 min intervals throughout the day. Geodesic distance was used to calculate the distance from the home address. Daily pain values were binned into high and low levels to compare to maximum daily excursions. Results: Individuals with average daily pain &gt; 2 traveled 4.1 fewer miles than those individuals reporting pain 2 exceeded a distance of 5 miles compared to 17.9% of those individuals reporting pain &lt;= 2 (X2=6.89, p &lt; 0.05). Conclusion: In older adults, higher level of knee pain is associated with a decline in life-space mobility. Using custom designed smartwatch applications provides new opportunity to investigate how pain impacts community mobility.

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