Patient-Reported Outcomes Integrated Within an Electronic Medical Record in Patients With Head and Neck Cancer

2021 ◽  
pp. 842-848
Author(s):  
Stephanie Ossowski ◽  
Amy Kammerer ◽  
Douglas Stram ◽  
Lisa Piazza-DeLap ◽  
Ethan Basch ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Cancer Therapy ◽  
Head And Neck ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Neck Cancer ◽  
Functional Assessment ◽  
Primary Language ◽  
Patient Reported ◽  
Pro Tools

PURPOSE Patient-reported outcome (PRO) tools lead to clinical benefits, including improved overall survival for patients with cancer. However, routine implementation of PROs in clinical practice within the electronic medical record (EMR) by integrated health care delivery systems remains limited. We studied the use of a PRO tool for patients with head and neck cancer (HNC) integrated in an EMR at Kaiser Permanente in Northern California. METHODS Between August 2017 and December 2019, patients with newly diagnosed HNC were surveyed at baseline, then every 3 months using the Functional Assessment of Cancer Therapy–General 7 and Functional Assessment of Cancer Therapy–Head and Neck (version 4). A medical assistant performed a baseline survey on diagnosis and then notified patients electronically per surveillance protocol. Patients who did not respond to online PRO surveys could complete them via telephone or in-person appointments with medical assistants. Abnormal findings on PRO surveys were referred to appropriate members of the care team or the treating Otolaryngology-Head and Neck Surgery physicians. RESULTS Two hundred ninety patients received baseline surveys. Patients received up to a maximum of eight subsequent surveys. Of a total of 597 electronic surveys, 585 (97.9%) were completed. The percentage of patients completing each interval survey ranged from 92% to 100%. Multivariate Poisson regression analysis showed patients with English as their primary language and an online secure account were the most likely to complete surveys compared with those patients with non-English as a primary language and without an online account. CONCLUSION PRO tools can be effectively used within the EMR for patients with HNC with a high response rate provided there is strong engagement from a dedicated member of the care team. This has important implications for designing clinical trials and symptom monitoring in clinical practices that incorporate EMRs.

Patient-reported outcomes integrated within electronic medical record in patients with head and neck cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14026-e14026
Author(s):  
Stephanie Ossowski ◽  
Amy Kammerer ◽  
Ethan M. Basch ◽  
Jed Abraham Katzel
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Neck Cancer ◽  
Care Team ◽  
Baseline Survey ◽  
Clinical Practices ◽  
Patient Reported ◽  
Pro Tools

e14026 Background: Patient-reported outcome (PRO) tools have been shown to improve outcomes including overall survival for cancer patients. However, routine implementation of PROs in clinical practice within the electronic medical record (EMR) remains limited. We studied the use of a PRO tool for patients with head and neck cancer (HNC) integrated in an EMR. Methods: Between August 2017 and December 2019 patients with newly diagnosed HNC were surveyed at baseline, then every 3 months using the FACT-G7 and FACT H&N (Version 4). A medical assistant (MA) performed a baseline survey around the time of diagnosis and then notified patients electronically every 3 months for two years and then every 6 months until patients completed their 5 years of surveillance. Patients who did not respond to online PRO surveys could complete them via telephone appointments with MAs, or in office pre-rooming. Abnormal findings on PRO surveys were referred to appropriate members of the care team or the treating ENT physicians. Results: 290 patients received baseline surveys. Patients received up to a maximum of 8 subsequent surveys (table). Out of a total of 597 electronic surveys, 585 (97.9%) were completed. The percentage of patient completing each survey ranged from 92-100%. Conclusions: PRO tools can be effectively deployed within the EMR for HNC patients with a high completion rate provided that there is strong engagement from a dedicated member of the care team. This has important implications for designing clinical trials and symptom monitoring in clinical practices that incorporate EMRs.

Effect of Epoetin Alfa on Survival and Cancer Treatment–Related Anemia and Fatigue in Patients Receiving Radical Radiotherapy With Curative Intent for Head and Neck Cancer

2009 ◽  
Vol 27 (34) ◽  
pp. 5751-5756 ◽  
Author(s):  
Peter J. Hoskin ◽  
Martin Robinson ◽  
Nicholas Slevin ◽  
David Morgan ◽  
Kevin Harrington ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Adverse Events ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Neck Cancer ◽  
Functional Assessment ◽  
Radical Radiotherapy ◽  
Epoetin Alfa ◽  
Local Tumor ◽  
Curative Intent

Purpose To evaluate the effect of epoetin alfa on local disease-free survival (DFS), overall survival (OS), and cancer treatment–related anemia and fatigue in patients with head and neck cancer receiving radical radiotherapy with curative intent. Patients and Methods Patients (N = 301) with hemoglobin (Hb) less than 15 g/dL were randomly assigned in a ratio of 1:1 to receive radiotherapy plus epoetin alfa (10,000 U subcutaneously [SC] three times weekly if baseline Hb was < 12.5 g/dL; 4,000 U SC three times weekly if baseline Hb ≥ 12.5 g/dL) or radiotherapy alone. Hb levels were monitored weekly. The primary end point was local DFS, defined as the time from random assignment to local disease recurrence or death. Secondary efficacy end points included OS, local tumor response, and local tumor control. Patients were followed at 1, 4, 8, and 12 weeks postradiotherapy and annually for 5 years. Cancer treatment–related anemia and fatigue were evaluated with the Functional Assessment of Cancer Therapy-Anemia and Functional Assessment of Cancer Therapy-Head and Neck. Adverse events were recorded up to 12 weeks postradiotherapy. Results Hb levels increased from baseline with epoetin alfa. The median duration of local DFS was not statistically different between groups (observation, 35.42 months; epoetin alfa, 31.47 months; hazard ratio, 1.04; 95% CI, 0.77 to 1.41). Groups did not significantly differ in DFS, OS, tumor outcomes, or cancer treatment–related anemia or fatigue. No new or unexpected adverse events were observed. Conclusion Addition of epoetin alfa to radical radiotherapy did not affect survival, tumor outcomes, anemia, or fatigue positively or negatively in patients with head and neck cancer.

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