scholarly journals Enabling symptom self-management via use of an electronic patient-reported outcomes (ePRO) system to increase self-efficacy of patients with cancer receiving active chemotherapy treatment

2016 ◽  
Vol 4 ◽  
Author(s):  
Kotronoulas Grigorios ◽  
Maguire Roma ◽  
Papadopoulou Constantina ◽  
Furlong Eileen ◽  
Fox Patricia ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Patient Reported Outcomes ◽  
Self Management ◽  
Chemotherapy Treatment ◽  
Patients With Cancer ◽  
Patient Reported

scholarly journals Web-Based Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care): Multicenter Pragmatic Nonrandomized Trial

10.2196/19685 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e19685
Author(s):  
Afaf Girgis ◽  
Ivana Durcinoska ◽  
Anthony Arnold ◽  
Joseph Descallar ◽  
Nasreen Kaadan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Reported Outcomes ◽  
Well Being ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Self Management ◽  
Diverse Population ◽  
Web Based ◽  
Patients With Cancer ◽  
Patient Reported

Background Despite the acceptability and efficacy of e–patient-reported outcome (ePRO) systems, implementation in routine clinical care remains challenging. Objective This pragmatic trial implemented the PROMPT-Care (Patient Reported Outcome Measures for Personalized Treatment and Care) web-based system into existing clinical workflows and evaluated its effectiveness among a diverse population of patients with cancer. Methods Adult patients with solid tumors receiving active treatment or follow-up care in four cancer centers were enrolled. The PROMPT-Care intervention supported patient management through (1) monthly off-site electronic PRO physical symptom and psychosocial well-being assessments, (2) automated electronic clinical alerts notifying the care team of unresolved clinical issues following two consecutive assessments, and (3) tailored online patient self-management resources. Propensity score matching was used to match controls with intervention patients in a 4:1 ratio for patient age, sex, and treatment status. The primary outcome was a reduction in emergency department presentations. Secondary outcomes were time spent on chemotherapy and the number of allied health service referrals. Results From April 2016 to October 2018, 328 patients from four public hospitals received the intervention. Matched controls (n=1312) comprised the general population of patients with cancer, seen at the participating hospitals during the study period. Emergency department visits were significantly reduced by 33% (P=.02) among patients receiving the intervention compared with patients in the matched controls. No significant associations were found in allied health referrals or time to end of chemotherapy. At baseline, the most common patient reported outcomes (above-threshold) were fatigue (39%), tiredness (38.4%), worry (32.9%), general wellbeing (32.9%), and sleep (24.1%), aligning with the most frequently accessed self-management domain pages of physical well-being (36%) and emotional well-being (23%). The majority of clinical feedback reports were reviewed by nursing staff (729/893, 82%), largely in response to the automated clinical alerts (n=877). Conclusions Algorithm-supported web-based systems utilizing patient reported outcomes in clinical practice reduced emergency department presentations among a diverse population of patients with cancer. This study also highlighted the importance of (1) automated triggers for reviewing above-threshold results in patient reports, rather than passive manual review of patient records; (2) the instrumental role nurses play in managing alerts; and (3) providing patients with resources to support guided self-management, where appropriate. Together, these factors will inform the integration of web-based PRO systems into future models of routine cancer care. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000615482; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370633 International Registered Report Identifier (IRRID) RR2-10.1186/s12885-018-4729-3

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.

scholarly journals Web-Based Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care): Multicenter Pragmatic Nonrandomized Trial (Preprint)

2020 ◽  
Author(s):  
Afaf Girgis ◽  
Ivana Durcinoska ◽  
Anthony Arnold ◽  
Joseph Descallar ◽  
Nasreen Kaadan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Reported Outcomes ◽  
Well Being ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Self Management ◽  
Diverse Population ◽  
Web Based ◽  
Patients With Cancer ◽  
Patient Reported

BACKGROUND Despite the acceptability and efficacy of e–patient-reported outcome (ePRO) systems, implementation in routine clinical care remains challenging. OBJECTIVE This pragmatic trial implemented the PROMPT-Care (Patient Reported Outcome Measures for Personalized Treatment and Care) web-based system into existing clinical workflows and evaluated its effectiveness among a diverse population of patients with cancer. METHODS Adult patients with solid tumors receiving active treatment or follow-up care in four cancer centers were enrolled. The PROMPT-Care intervention supported patient management through (1) monthly off-site electronic PRO physical symptom and psychosocial well-being assessments, (2) automated electronic clinical alerts notifying the care team of unresolved clinical issues following two consecutive assessments, and (3) tailored online patient self-management resources. Propensity score matching was used to match controls with intervention patients in a 4:1 ratio for patient age, sex, and treatment status. The primary outcome was a reduction in emergency department presentations. Secondary outcomes were time spent on chemotherapy and the number of allied health service referrals. RESULTS From April 2016 to October 2018, 328 patients from four public hospitals received the intervention. Matched controls (n=1312) comprised the general population of patients with cancer, seen at the participating hospitals during the study period. Emergency department visits were significantly reduced by 33% (<i>P</i>=.02) among patients receiving the intervention compared with patients in the matched controls. No significant associations were found in allied health referrals or time to end of chemotherapy. At baseline, the most common patient reported outcomes (above-threshold) were fatigue (39%), tiredness (38.4%), worry (32.9%), general wellbeing (32.9%), and sleep (24.1%), aligning with the most frequently accessed self-management domain pages of physical well-being (36%) and emotional well-being (23%). The majority of clinical feedback reports were reviewed by nursing staff (729/893, 82%), largely in response to the automated clinical alerts (n=877). CONCLUSIONS Algorithm-supported web-based systems utilizing patient reported outcomes in clinical practice reduced emergency department presentations among a diverse population of patients with cancer. This study also highlighted the importance of (1) automated triggers for reviewing above-threshold results in patient reports, rather than passive manual review of patient records; (2) the instrumental role nurses play in managing alerts; and (3) providing patients with resources to support guided self-management, where appropriate. Together, these factors will inform the integration of web-based PRO systems into future models of routine cancer care. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12616000615482; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370633 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12885-018-4729-3

scholarly journals Treatment response and several patient-reported outcomes are early determinants of future self-efficacy in rheumatoid arthritis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Doumen Michaël ◽  
De Cock Diederik ◽  
Pazmino Sofia ◽  
Bertrand Delphine ◽  
Joly Johan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Response ◽  
Self Efficacy ◽  
Global Assessment ◽  
Patient Reported Outcomes ◽  
Self Management ◽  
Remission Induction ◽  
Early Ra ◽  
Sf 36 ◽  
Patient Reported

Abstract Background Self-efficacy, or patients’ confidence in their ability to control disease and its consequences, was recently prioritised in EULAR recommendations for inflammatory arthritis self-management strategies. However, it remains unclear which factors influence self-efficacy in early rheumatoid arthritis (RA). Methods Data were analysed from the 2-year RCT Care in early RA (CareRA), which studied remission-induction treatment regimens for early RA. Participants completed the Arthritis Self-Efficacy Scale (ASES), Short-Form 36 (SF-36), Revised Illness Perception Questionnaire (IPQ-R), Utrecht Coping List (UCL), RAQoL and Health Assessment Questionnaire (HAQ). Depending on time to first remission (DAS28-CRP < 2.6) and persistence of remission, treatment response was defined as persistent response, secondary failure, delayed response, late response or non-response. The association between ASES scores and clinical/psychosocial factors was explored with Spearman correlation and multivariate linear mixed models. Baseline predictors of week 104 ASES were identified with exploratory linear regression followed by multiple regression of significant predictors adjusted for DAS28-CRP, HAQ, treatment arm, treatment response, cumulative CRP/SJC28 and demographic/serologic confounders. Results All 379 patients had a recent diagnosis of RA and were DMARD-naïve at study initiation. Most patients were women (69%) and RF/ACPA-positive (66%), and the mean (SD) age was 52 (13) years. For all tested outcome measures, better perceived health correlated with higher self-efficacy. While patient-reported factors (HAQ, SF-36, RAQoL, IPQ-R, pain, fatigue and patient’s global assessment) showed moderate/strong correlations with ASES scores, correlations with physician-reported factors (physician’s global assessment, SJC28), TJC28 and DAS28-CRP were weak. Only more favourable outcomes on patient-reported factors and DAS28-CRP were associated with higher ASES scores at each time point. An earlier, persistent treatment response predicted higher ASES scores at both weeks 52 and 104. Significant baseline predictors of week 104 ASES included HAQ; SF-36 mental component score, vitality, mental health and role emotional; IPQ-R illness coherence, treatment control, emotional representations and consequences; UCL Passive reacting; and the RAQoL. Conclusions Patient-reported outcomes and treatment response were early determinants of long-term self-efficacy in an early RA trial. These results provide further relevance for the window of opportunity in an early treat-to-target strategy and could help to timely identify patients who might benefit from self-management interventions. Trial registration EudraCT 2008-007225-39

scholarly journals The role of EORTC QLQ-C15-PAL scores and inflammatory biomarkers in predicting survival in terminally ill patients with cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Yoshihiro Shitashimizu ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Cox Regression ◽  
Terminally Ill ◽  
Inflammatory Biomarkers ◽  
Survival Curves ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Patient Reported ◽  
Eortc Qlq

Abstract Background The clinical use of patient-reported outcomes as compared to inflammatory biomarkers for predicting cancer survival remains a challenge in palliative care settings. We evaluated the role of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative scores (EORTC QLQ-C15-PAL) and the inflammatory biomarkers C-reactive protein (CRP), albumin (Alb), and neutrophil-lymphocyte ratio (NLR) for survival prediction in patients with advanced cancer. Methods This was an observational study in terminally ill patients with cancer hospitalized in a palliative care unit between June 2018 and December 2019. Patients’ data collected at the time of hospitalization were analyzed. Cox regression was performed to examine significant factors influencing survival. A receiver operating characteristic (ROC) analysis was performed to estimate cut-off values for predicting survival within 3 weeks, and a log-rank test was performed to compare survival curves between groups divided by the cut-off values. Results Totally, 130 patients participated in the study. Cox regression suggested that the QLQ-C15-PAL dyspnea and fatigue scores and levels of CRP, Alb, and NLR were significantly associated with survival time, and cut-off values were 66.67, 66.67, 3.0 mg/dL, 2.5 g/dL, and 8.2, respectively. The areas under ROC curves of these variables were 0.6–0.7. There were statistically significant differences in the survival curves between groups categorized using each of these cut-off values (p < .05 for all cases). Conclusion Our findings suggest that the assessment of not only objective indicators for the systemic inflammatory response but also patient-reported outcomes using EORTC QLQ-C15-PAL is beneficial for the prediction of short-term survival in terminally ill patients with cancer.

scholarly journals P342 Maladaptive coping, self-efficacy and patient reported outcomes in inflammatory bowel disease

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S250-S251
Author(s):  
C.-Y. Chao ◽  
C. Lemieux ◽  
W. Afif ◽  
A. Bitton ◽  
G. Wild ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Self Efficacy ◽  
Patient Reported Outcomes ◽  
Maladaptive Coping ◽  
Patient Reported ◽  
Inflammatory Bowel

scholarly journals Sometimes more is more: iterative participatory design of infographics for engagement of community members with varying levels of health literacy

2015 ◽  
Vol 23 (1) ◽  
pp. 174-183 ◽  
Author(s):  
Adriana Arcia ◽  
Niurka Suero-Tejeda ◽  
Michael E Bales ◽  
Jacqueline A Merrill ◽  
Sunmoo Yoon ◽  
...  
Keyword(s):  
Health Literacy ◽  
Participatory Design ◽  
Patient Reported Outcomes ◽  
Self Management ◽  
Community Members ◽  
Health Promoting Behaviors ◽  
Clinical Communication ◽  
Learning Health System ◽  
Patient Reported ◽  
Health Promoting

Abstract Objective To collaborate with community members to develop tailored infographics that support comprehension of health information, engage the viewer, and may have the potential to motivate health-promoting behaviors. Methods The authors conducted participatory design sessions with community members, who were purposively sampled and grouped by preferred language (English, Spanish), age group (18–30, 31–60, &gt;60 years), and level of health literacy (adequate, marginal, inadequate). Research staff elicited perceived meaning of each infographic, preferences between infographics, suggestions for improvement, and whether or not the infographics would motivate health-promoting behavior. Analysis and infographic refinement were iterative and concurrent with data collection. Results Successful designs were information-rich, supported comparison, provided context, and/or employed familiar color and symbolic analogies. Infographics that employed repeated icons to represent multiple instances of a more general class of things (e.g., apple icons to represent fruit servings) were interpreted in a rigidly literal fashion and thus were unsuitable for this community. Preliminary findings suggest that infographics may motivate health-promoting behaviors. Discussion Infographics should be information-rich, contextualize the information for the viewer, and yield an accurate meaning even if interpreted literally. Conclusion Carefully designed infographics can be useful tools to support comprehension and thus help patients engage with their own health data. Infographics may contribute to patients’ ability to participate in the Learning Health System through participation in the development of a robust data utility, use of clinical communication tools for health self-management, and involvement in building knowledge through patient-reported outcomes.

Sa1905 The Impact of Medication Self-Efficacy and Health Literacy on Patient-Reported Outcomes in Inflammatory Bowel Disease

2016 ◽  
Vol 150 (4) ◽  
pp. S398-S399
Author(s):  
Lauren K. Tormey ◽  
Jason S. Reich ◽  
Sarah Chen ◽  
Zachary Lipkin-Moore ◽  
Anzhu Yu ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Health Literacy ◽  
Bowel Disease ◽  
Self Efficacy ◽  
Patient Reported Outcomes ◽  
Patient Reported ◽  
Inflammatory Bowel ◽  
The Impact

scholarly journals Influence of self-management on patient-reported outcomes for individuals with chronic heart failure: a multilevel model approach from a longitudinal study

2020 ◽  
Author(s):  
Jing Tian ◽  
Jinghua Zhao ◽  
Qing Zhang ◽  
Jia Ren ◽  
Linai Han ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Patient Reported Outcomes ◽  
Multilevel Models ◽  
Management Strategies ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Self Management ◽  
Converting Enzyme Inhibitors ◽  
Patient Reported ◽  
Improve Patient

Abstract Purpose: Self-management is highly heterogenous in patient-reported outcomes in individuals with chronic heart failure and lacks a clinical definition. The aim of this study was to identify clinically meaningful strategies that improve patient-reported outcomes in those with chronic heart failure.Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from May 2017 to May 2019. Self-management advice was provided in written form at discharge. Information regarding chronic heart failure in patient-reported outcomes and self-management was collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of self-management strategies for patient-reported outcome of chronic heart failure (CHF-PRO) scores, as well as its physical and psychological domains. Minimal clinically important difference was introduced to further evaluate clinical significance.Results: Scores for CHF-PRO improved significantly after discharge. A regular schedule, avoidance of over-eating, and a low-sodium diet increased scores on patient-reported outcomes, including overall scores and physical and psychological scores. In addition, exercise improved patient-reported outcomes and its physical domain. The use of angiotensin-converting enzyme inhibitors also increased physical scores. Among these variables, a regular daily schedule and avoidance of over-eating almost every day reached clinical significance for CHF-PRO scores, as well as its physical and psychological domains.Conclusions: Self-management, especially the avoidance of over-eating and maintenance of a regular schedule, should be implemented to improve patient-reported outcomes in those with chronic heart failure.Trial registration: 2018LL128, January 2, 2018.

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