A narrative review exploring the professional practice training requirement of therapeutic radiographers undertaking effective remote/telephone review clinics in place of face-to-face radiographer-led review clinics during the COVID-19 pandemic

Abstract Background and purpose: The COVID-19 pandemic has led to the introduction of alternative on-treatment and post-treatment radiographer-led review clinics in an attempt to protect patients, staff and the public. Pre-COVID, patient reviews were routinely undertaken face-to-face, led by therapeutic review radiographers with advanced practice qualifications and skills in radiotherapy symptom management, triage, referral and support services. During the COVID-19 pandemic, an alternative option has been to follow-up in the form of telephone reviews to reduce face-to-face exposure whilst continuing to manage patient radiotherapy treatment-related toxicities. The aim of the narrative review is to explore the subject of telephone reviews and how therapeutic review radiographers might need to adapt communication skills so that they can continue to effectively assess and manage radiotherapy patient treatment reactions remotely. Method and discussion: A narrative review was conducted using the SCOPUS database and 28 publications were included from 2013 to 2021. The review highlights a paucity of literature exploring specific telephone training for radiographers and other allied healthcare professionals. Experiences within medical and nursing programmes demonstrate that development and integration of training in this area is critical in preparing for patient interaction via telephone. Conclusion and implications for practice: Multiple teaching modalities including simulation are ideal for teaching telephone-specific skills and content, demonstrating improvement in student knowledge, competence and confidence. Less is known regarding whether this knowledge translates to an improved patient experience. Enhancements in education and training, guided by the Health and Care Professions Council, may be warranted to ensure that patients continue to receive the optimal quality of care in a world where remote reviews are likely to become commonplace. Patient-reported outcome measures might be utilized for future training evaluations to ensure that effective patient care is being maintained.

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The role of response domain and scale label in the quantitative interpretation of patient-reported outcome measure response options

Quality of Life Research ◽

10.1007/s11136-021-02801-9 ◽

2021 ◽

Author(s):

Tessa Peasgood ◽

Jen-Yu Chang ◽

Robina Mir ◽

Clara Mukuria ◽

Philip A. Powell

Keyword(s):

First Language ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Response Options ◽

The Public ◽

Online Panel ◽

Patient Reported ◽

Common Response ◽

Chi Squared

Abstract Purpose Uncertainties exist in how respondents interpret response options in patient-reported outcome measures (PROMs), particularly across different domains and for different scale labels. The current study assessed how respondents quantitatively interpret common response options. Methods Members of the general public were recruited to this study via an online panel, stratified by age, gender, and having English as a first language. Participants completed background questions and were randomised to answer questions on one of three domains (i.e. loneliness (negatively phrased), happiness or activities (positively phrased)). Participants were asked to provide quantitative interpretations of response options (e.g. how many times per week is equal to “often”) and to order several common response options (e.g. occasionally, sometimes) on a 0–100 slider scale. Chi-squared tests and regression analyses were used to assess whether response options were interpreted consistently across domains and respondent characteristics. Results Data from 1377 participants were analysed. There was general consistency in quantifying the number of times over the last 7 days to which each response option referred. Response options were consistently assigned a lower value in the loneliness than happiness and activities domains. Individual differences, such as age and English as a second language, explained some significant variation in responses, but less than domain. Conclusion Members of the public quantify common response options in a similar way, but their quantification is not equivalent across domains or every type of respondent. Recommendations for the use of certain scale labels over others in PROM development are provided.

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Patient reported outcome measures in rare diseases: a narrative review

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-018-0810-x ◽

2018 ◽

Vol 13 (1) ◽

Cited By ~ 34

Author(s):

Anita Slade ◽

Fatima Isa ◽

Derek Kyte ◽

Tanya Pankhurst ◽

Larissa Kerecuk ◽

...

Keyword(s):

Outcome Measures ◽

Rare Diseases ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Narrative Review ◽

Patient Reported

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Digital patient-reported outcome measures (PROMs) for remote monitoring of patients on cancer treatment: a cross-sectional questionnaire feasibility study (Preprint)

10.2196/preprints.18502 ◽

2020 ◽

Author(s):

Mayuran Ananth Sivanandan ◽

Catherine Sharma ◽

Pippa Bullard ◽

Judith Christian

Keyword(s):

Cancer Treatment ◽

Outcome Measures ◽

Remote Monitoring ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Severe Toxicity ◽

Cross Sectional ◽

Treatment Pathways ◽

Face To Face ◽

Patient Reported

BACKGROUND Oncology has increasing outpatient activity related to increased cancer incidence, better survival rates and more treatments. Innovative technological solutions could help deal with this increasing demand and digital patient-reported outcome measures (PROMs) to identify those patients that need a face-to-face (FTF) appointment is one potential approach. OBJECTIVE Our study aimed to assess the feasibility of digital PROM questionnaires to enable remote symptom monitoring for patients on cancer treatment and their ability to determine the requirement for a FTF appointment. METHODS This study was performed at a tertiary oncology centre between December 2018 and February 2019. Target clinics covered both systemic therapy and radiotherapy cohorts. The Common Terminology Criteria for Adverse Events (CTCAE) helped form the basis for acute toxicity questionnaires which were adapted into patient-friendly language. Treatment-specific digital PROM questionnaires were answered by patients and their clinicians alongside face-to-face appointments. Patients and clinicians did not see each other’s results, which were not used for clinical decisions. Agreement between patients and clinicians was assessed through descriptive statistics. Patient and staff feedback was also obtained. RESULTS 90 patients took part in the study across 10 different treatment pathways. By comparing paired patient and clinician responses, the sensitivity of the patient-completed questionnaires in correctly determining the need for FTF review was 93.6% and no patients with severe toxicity would have been missed with the questionnaires. Digital PROMs revealed 28.9% of participating patients did not need FTF review based on their symptoms. Certain oncological treatment pathways, such as immunotherapy, were found to have a larger proportion of patients with minimal symptoms compared to others, such as conventional chemotherapy. Patient and staff feedback showed high approval with digital PROMs and their potential for use in remote monitoring. CONCLUSIONS Digital PROM questionnaires can feasibly determine the need for FTF review in ‘on treatment’ oncology clinics. Their use with specific treatments could safely reduce the requirement for FTF care and future work should evaluate their application in the remote monitoring of patients.

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280 The Use of Telemedicine in Plastics Surgery During COVID-19: A Single-Centre Correlation Study with Patient Reported Outcome Measures

British Journal of Surgery ◽

10.1093/bjs/znab259.449 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

D Rojoa ◽

F Raheman ◽

A Ibrahim ◽

N Patel

Keyword(s):

Wound Care ◽

Fold Increase ◽

Wound Complication ◽

Patient Reported Outcome Measures ◽

Correlation Study ◽

Patient Reported Outcome ◽

Complication Rates ◽

Face To Face ◽

Patient Reported ◽

The Impact

Abstract Aim With enforcement of social distancing measures during the COVID-19 pandemic, face-to-face patient contact was shifted to telemedicine consultations. There is limited evidence evaluating patient experience of follow-ups and expectations into quality metrics. Our aim was to perform a service evaluation by prospectively evaluating the management and outcomes of plastic surgery patients. Method Patients were consecutively assessed over the COVID-19 lockdown period, from March to May 2020. They ranged from urgent cancer cases to burns and trauma. We used a questionnaire to evaluate initial treatment, wound care, complications, and overall service. A validated health-related quality of life (HRQL) survey was used to assess the impact of injury or wound on lifestyle and we also assessed patient enablement. Correlation analysis determined relationships between outcomes, service evaluations and HRQL variables. Results 77 patients were consecutively treated in our unit, of which 46 completed the questionnaire. 42.2% used multimedia as mode of follow-up, including smart phones for messages and videocalls, and trust e-mails. There was a 3-fold increase in number of infections for non-face-to-face consultations, with a correlation significance of 0.043. We found no correlation between age and wound complication rates. 72.7% of patients found overall service very good or excellent. Although overall service satisfaction was similar for multimedia use and face-to-face consultations (p = 0.02), less patients were confident looking after their wound without face-to-face follow-ups. Conclusions COVID-19 has brought upon an unprecedented change in practice in our department. Implementing multimedia use and educating patients on wound care can significantly improve efficiency and service provision.

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Red cell transfusion benefits in oncology, haematology and palliative medicine populations: a narrative review

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2021-003052 ◽

2021 ◽

pp. bmjspcare-2021-003052

Author(s):

Ed Duffy ◽

Frances O’Mahony ◽

Caroline Burke ◽

Aoibheann Conneely ◽

Helen O’Connell ◽

...

Keyword(s):

Outcome Measures ◽

Palliative Medicine ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Narrative Review ◽

Red Cell ◽

Subjective Response ◽

Advanced Malignancy ◽

Patient Reported ◽

Red Cell Transfusion

Due to the heterogenous nature of the palliative medicine patient population, assessment of benefit, and thus choice of appropriate patient for consideration of transfusion, can be challenging. This can be confounded by the use of both liberal and restrictive transfusion thresholds. The multifactorial nature of many symptoms of anaemia, particularly in patients with advanced malignancy, can further complicate. As such, there is a paucity of data supporting the subjective, objective and clinical benefit of red cell transfusion in the palliative medicine setting. This narrative review summarises the research and evidence surrounding the benefits of red cell transfusion, with a particular emphasis on the oncological, haematological and palliative medicine population. There is a lack of a validated, reproducible patient-reported outcome measures (PROM) to assess response to red cell transfusions in the palliative medicine population with outcome measures varying from objective improvement in haemoglobin level post-transfusion, to subjective response in primary symptom(s). Further investigation is required regarding the development of effective PROMs assessing response to red cell transfusion in the palliative medicine population, to ensure judicious use of this scarce and valuable resource.

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P71 Working collaboratively with patients as research partners in the co-production of the WASTEd: a measure of fatigue and energy in axial spondyloarthritis (axSpA)

Rheumatology ◽

10.1093/rheumatology/keaa111.070 ◽

2020 ◽

Vol 59 (Supplement_2) ◽

Author(s):

Nathan A Pearson ◽

George Strickland ◽

Jean Thompson ◽

Jane Martindale ◽

Elizabeth Tutton ◽

...

Keyword(s):

Axial Spondyloarthritis ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Face To Face ◽

Active Involvement ◽

Measurement Framework ◽

Question Item ◽

Health And Social Care ◽

Patient Reported ◽

Key Issues

Abstract Background The last decade has witnessed significant growth in the active involvement of patients as research partners (PRPs) in health and social care research to facilitate a stronger patient-focus in research endeavours and outputs. Whilst general guidance is available - e.g. INVOLVE - there is limited guidance pertaining to how one should collaborate with patients as partners in the development of patient-reported outcome measures (PROMs). Here, we describe our active collaboration with patients as research partners in the co-production of a new PROM: the Warwick Axial Spondyloarthritis measure of faTigue and Energy (WASTEd). Methods An established PRP group contributed to the development of the initial funding application, whom received training and support from the PRP group facilitator (JM). The key stages for PRP collaboration throughout the PROM development process were jointly agreed and included: developing qualitative research topic guides and supporting data analysis; supporting development and refinement of the measurement framework to underpin the new PROM, and; supporting question (item) generation and refinement following both qualitative and quantitative explorations. All key decisions were made following face-to-face meetings between the lead research and the PRP group. Results Six face-to-face meetings were held over 2.5 years (average meeting duration 2 hours; range 1.5 to 3 hours) with between three and eight PRP members attended each meeting. Additional e-mail correspondence and summary reports were shared between meetings. The group contributed across all project stages including: developing ethics applications which included assessing the acceptability of the study to patients; generating interview topic guides and verbal probes for key issues identified by the PRP group; interpreting qualitative data with the lead researcher; co-designing and editing the draft PROM and refining the long form version of the PROM using both qualitative and statistical data. PRP collaboration was particularly integral to the appropriate use of relevant language and, most substantively, in providing a clearer understanding of the distinction between fatigue and energy. Conclusion The active collaboration with PRPs has supported the co-production of a relevant and acceptable PROM, driven by the needs and perspectives of patients. Additionally, the PRP groups were able to ensure all refinement decisions made to the PROM did not undermine the content validity of the measure. Finally, their involvement has sought to act as a check, support and challenge on inferences drawn by the researchers, enriching the process and study outcomes. Disclosures N.A. Pearson None. G. Strickland None. J. Thompson None. J. Martindale Honoraria; JM has received speaker fees and/or honoraria from Abbvie Ltd, Novartis, Pfizer and UCB. Grants/research support; JM has received a research grant from Pfizer. E. Tutton None. H. Parsons None. J. Packham None. K. Haywood None.

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