Developing symptom management quality improvement reports with data from a registry-based patient reported outcomes (PRO) collection method.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 180-180
Author(s):  
Tenbroeck Smith ◽  
Kathleen Castro ◽  
Alyssa Troeschel ◽  
Neeraj K. Arora ◽  
Kevin Stein ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Professional ◽  
Symptom Management ◽  
Patient Reported Outcomes ◽  
Standards Of Care ◽  
Cancer Type ◽  
Cancer Centers ◽  
Quality Reporting ◽  
Management Quality ◽  
Patient Reported

180 Background: Symptom management is critical to quality cancer care, affecting treatment completion, functioning and quality of life. We describe the use of the Commission on Cancer’s Rapid Quality Reporting System (RQRS) to ascertain cases for PRO collection, identify key PRO quality indicators, and provide actionable symptom management quality improvement (QI) reports to community cancer centers (CCC). Methods: The Patient Reported Outcomes Symptoms & Side Effects Study used RQRS to sample patients (pt) 4-12 months from diagnosis with locoregional breast/colon from 17 National Cancer Institute Community Cancer Centers Program centers. Surveys were mailed with web option. Pts were asked if they talked to a health professional about pain (Talk about) and, separately, if the health professional gave advice about what to do if pain started, got worse, or came back (Advice). Similar questions were asked about fatigue and emotional distress (ED). QI reports were designed with CCC staff feedback and produced for each CCC providing crude and case-mix adjusted CCC-specific rates, and study-wide rates. Direct standardization methods were used to adjust CCC-specific rates for cancer type and education. Results: 2,487 eligible participants responded (RR=61%). This table shows overall study-wide estimates and the range of adjusted CCC-specific estimates for six key indicators. (See Table.) Conclusions: This pilot study shows the registry-based method for PRO collection was successful and has potential for wider dissemination. Study-wide, 20-45% of pts did not report discussing or getting advice about three common symptoms from their healthcare team. CCCs varied significantly on these indicators, suggesting room for improvement. Quality reports were well received by hospital staff, who report sharing them with clinicians, navigators and cancer committees. CCC-specific reports may promote efforts to improve care through professional/patient education and applying standards of care. [Table: see text]

scholarly journals Using patient reported outcomes in oncology clinical practice

2016 ◽  
Vol 13 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Sarah A. Kelleher ◽  
Tamara J. Somers ◽  
Tracie Locklear ◽  
Alexandra D. Crosswell ◽  
Amy P. Abernethy
Keyword(s):  
Symptom Severity ◽  
Psychosocial Functioning ◽  
Self Efficacy ◽  
Symptom Management ◽  
Patient Reported Outcomes ◽  
Tablet Computer ◽  
Cancer Type ◽  
Pain Symptom ◽  
Patients With Cancer ◽  
Patient Reported

AbstractBackground and aimsPatient reported outcomes (PROs) are increasingly being implemented into the care of patients with cancer. The use of a standard set of PROs (e.g., pain) in cancer is becoming established and there is interest in what additional PROs might provide valuable information. The goal of this observational study was to examine how the PROs of self-efficacy for pain and other symptoms assessed at the point of service were associated with pain, symptom severity and distress, and physical and psychosocial functioning in a sample of breast and gastrointestinal patients. We also sought to examine differences in these relationships by cancer type (breast and gastrointestinal) as well as understand differences in self-assessment mode (paper/pencil or electronic tablet).Methods178 patients with breast (n = 65) and gastrointestinal cancer (n = 113) completed the Chronic Pain Self Efficacy Scale, M.D. Anderson Symptom Inventory, and Functional Assessment of Cancer Therapy – General questionnaires. Measures were completed with paper and pencil and electronically using a tablet computer while patients waited for their clinical appointment. Responses from the initial completed questionnaires on both the paper and electronic instruments were analyzed.ResultsPatients’ self-efficacy scores for pain and other symptoms correlated positively with pain, symptom severity and distress, and physical and psychosocial functioning; patients with lower levels of self-efficacy reported poorer outcomes and functioning overall. The results were independent of cancer type and mode of assessment. No statistically significant differences were found in the PROs when collected by electronic technology versus paper-pencil mode; patients were very satisfied with using the tablet computer to complete the PRO measures.Conclusions and implicationsOur results suggest that self-efficacy for pain and symptom management may be a beneficial addition to clinic-based PRO assessment batteries for patients with cancer and other chronic diseases. Existing short, validated symptom self-efficacy scales could easily be integrated into clinical practice to help healthcare providers identify patients that might benefit from intervention. Study results also support existing research that suggests electronic approaches are a practical way to collect PRO data, including self-efficacy data, in the clinic. Overall, our data suggest that patients who have particularly low levels of self-efficacy for pain and symptom management may be at risk for higher levels of pain and disability. Thus, if self-efficacy for pain and symptom management were routinely collected at the time of clinical service, psychosocial interventions to improve self-efficacy for pain and symptom management, and in turn overall quality of life, could be implemented in a timely fashion.

The development and acceptability of symptom management quality improvement reports based on patient-reported data: an overview of methods used in PROSSES

2016 ◽  
Vol 25 (11) ◽  
pp. 2833-2843 ◽  
Author(s):  
Alyssa Troeschel ◽  
Tenbroeck Smith ◽  
Kathleen Castro ◽  
Katherine Treiman ◽  
Joseph Lipscomb ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Symptom Management ◽  
Management Quality ◽  
Patient Reported ◽  
Reported Data

scholarly journals The HOPE Pilot Study: Harnessing Patient-Reported Outcomes and Biometric Data to Enhance Cancer Care

2018 ◽  
pp. 1-12 ◽  
Author(s):  
Alexi A. Wright ◽  
Nikita Raman ◽  
Patrick Staples ◽  
Stephanie Schonholz ◽  
Angel Cronin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Status ◽  
Clinical Outcomes ◽  
Mobile Health ◽  
Symptom Management ◽  
Patient Reported Outcomes ◽  
Perceived Effectiveness ◽  
Activity Data ◽  
Patient Reported ◽  
Wearable Accelerometers

Purpose Integrating patient-reported outcomes (PROs) into clinical practice is an increasingly promising strategy for improving patients’ symptoms, communication, and clinical outcomes. The objective of the current study was to assess the feasibility, acceptability, and perceived effectiveness of a mobile health intervention that was designed to collect PROs and activity data as a measure of health status. Patients and Methods This work was a pilot intervention with 10 patients with gynecologic cancers who received palliative chemotherapy. The HOPE (Helping Our Patients Excel) study used wearable accelerometers to assess physical activity and the Beiwe research platform to collect PROs, stratify patient responses by risk, provide tailored symptom management, and notify patients and clinicians of high-risk symptoms. Feasibility and acceptability were assessed through enrollment and adherence rates, and perceived effectiveness was evaluated by patients and oncologists at study completion. Results The approach-to-consent rate was 100%, and participants were 90% and 70% adherent to the wearable accelerometers and smartphone surveys, respectively. Participants’ mean daily step count was 3,973 (standard deviation [SD], 2,305 steps) and increased from week 1 (mean, 3,520 steps; SD, 1,937 steps) to week 3 (mean, 4,136 steps; SD, 1,578 steps). Active monitoring of participants’ heart rates, daily steps, and PROs throughout the study identified anomalies in participants’ behavior patterns that suggested poor health for two patients (20%). Patients and clinicians indicated that the intervention improved physical activity, communication, and symptom management. Conclusion A mobile health intervention that collects PROs and activity data as a measure of health status is feasible, acceptable, and was perceived to be effective in improving symptom management in patients with advanced gynecologic cancers. A larger, multisite, randomized clinical trial to assess the efficacy of the HOPE intervention on patients’ symptoms, health-related quality of life, clinical outcomes, and health care use is warranted.

Evaluation of an interactive patient-reported outcome (I-PRO) system in outpatients receiving oral chemotherapy..

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18208-e18208
Author(s):  
Marika Anna Rasschaert ◽  
Jan Van den Brande ◽  
Konstantinos Papadimitriou ◽  
Pol Specenier ◽  
Sven De Keersmaecker ◽  
...  
Keyword(s):  
Symptom Management ◽  
Treatment Compliance ◽  
Skin Toxicity ◽  
Patient Reported Outcome ◽  
Outpatient Setting ◽  
International Standards ◽  
Standards Of Care ◽  
Time Data ◽  
Central Platform ◽  
Patient Reported

e18208 Background: Health Information Technology (HIT) is increasingly integrated in clinical cancer care. Simultaneous routine assessment of patient reported outcomes (PROs) reliably improve symptom management, patient-provider communication and ultimately survival. Methods: his pilot study is a single center experience with the development and validation of an I-PRO tool (AMOCT). After obtaining informed consent, outpatients, using oral anticancer treatment, recorded their medication intake and 17 PRO measures (PROM) using this I-PRO tool. The device allowed real time data collection via a central platform. The registered data were processed by an algorithm, which stratifies the data into different grades according to international standards of care (CTCAE v4.0). In response to registration of data, patients received either automated symptom management suggestions or were referred to their caregivers. Patient clinical and demographic information is collected from medical records and analyzed using descriptive statistics. Results: 63 Patients were included, 51% male, mean age 61.5 (range 28-83). 41% Of patients used capecitabine, 24% regorafenib, 16% TAS 102, 5% pazopanib and 5% sunitinib. Of the 1873 PROM-scores, 308 scores needed nurses’ attention, ultimately leading to dose reductions in 7 patients (12%). Most often due to weight loss, skin toxicity and asthenia. 41 Patients stopped registration: 51% because treatment ended, 27 % died, 10% dropped out, 5% progressed, 5% were lost to follow up and 2% never started. This tool was well adopted and demonstrated treatment compliance in > 85% patients. Conclusions: This study confirms the feasibility of the program, in an outpatient setting. This I-PRO tool provides a means to register compliance and toxicity of treatment. The compliance to the I-PRO tool will be confirmed, with further development of this program in a multicenter, randomized design. Evaluation of quality of life, PROM’s and further exploration of the relationship between optimal pharmacovigilance and improvement of patient’s outcome will ensue.

scholarly journals Feasibility of Collecting Patient-Reported Outcomes for Inpatient Rehabilitation Quality Reporting

2017 ◽  
Vol 53 (3) ◽  
pp. 1834-1850 ◽  
Author(s):  
Allen Walter Heinemann ◽  
Anne Deutsch ◽  
David Cella ◽  
Karon Frances Cook ◽  
Linda Foster ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Inpatient Rehabilitation ◽  
Quality Reporting ◽  
Patient Reported
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