eHealth System for Collecting and Utilizing Patient Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) Among Cancer Patients: Mixed Methods Approach to Evaluate Feasibility and Acceptability.
eHealth System for Collecting and Utilizing Patient Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) Among Cancer Patients: Mixed Methods Approach to Evaluate Feasibility and Acceptability.
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DOI：
10.2196/jmir.8360
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发表时间：
2017-10-02
影响因子：
7.4
通讯作者：
PROMPT-Care Program Group
中科院分区：
文献类型：
--
作者：
Girgis A;Durcinoska I;Levesque JV;Gerges M;Sandell T;Arnold A;Delaney GP;PROMPT-Care Program Group
尽管越来越多的证据表明，收集患者报告的结果（PROs）并将结果实时传递给治疗卫生专业人员有可能改善患者的健康和癌症预后，但这种做法并不普遍。本研究的目的是测试PROMPT-Care（患者报告的个性化治疗和护理结果测量）的可行性和可接受性，这是一种新开发的电子健康（eHealth）系统，可促进从癌症患者中获取PRO数据，数据链接和检索以支持临床决策和患者自我管理，数据检索以支持正在进行的评估和创新研究。我们与特定内容的专家咨询小组协商，开发了一个电子卫生系统，并在澳大利亚新南威尔士州的两家医院对接受治疗或后续护理的患者进行了为期3个月的测试。参与者在诊所招募，并在即将到来的临床咨询之前或在随访治疗中每4周完成基于网络的自我报告评估。采用混合方法评价即时护理的可行性和可接受性；在整个研究过程中收集的数据告知了数据传输程序的准确性和完整性，并且从参与者的评估中确定了缺失数据的程度。患者在完成第一次评估时参加认知访谈，并在研究结束时完成评估调查和访谈，以评估患者自我管理资源的系统可接受性和有用性，在研究结束时对肿瘤科工作人员进行访谈，以确定实时PRO报告的可接受性和感知有用性。共有42名患者同意这项研究；7例患者在开始干预前退出，主要是因为资格的改变。总体而言，35名患者（13名接受治疗，22名接受随访）在研究期间完成了67项评估。患者报告数据的平均完整性为93%，数据传输的准确性为100%。在研究结束时，10名患者完成了认知访谈，28名患者完成了评估调查，14名患者完成了评估访谈。PROMPT-Care患者可接受性高——100%（28/28）的患者表示完成基于网络的评估的时间（平均15分钟）大致合适，大多数人愿意回答更多的问题（79%，22/28是），96%（27/28）的患者认为基于网络的评估更容易或与完成纸质副本相同，他们重视自我管理资源。肿瘤学工作人员（n=5）也报告了该系统的高可接受性和潜在可行性。患者和肿瘤工作人员对PROMPT-Care系统的接受度很高，结果表明在肿瘤环境中实施它是可行的。建议对患者评估调查、临床医生对报告的访问和系统要求进行修改，作为下一阶段大规模测试的一部分，并作为常规护理的一部分在未来实施该系统。澳大利亚新西兰临床试验注册中心ACTRN1261500135294；https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369299&isReview=true（由WebCite在http://www.webcitation.org/6lzylG5A0存档）。
Despite accumulating evidence indicating that collecting patient-reported outcomes (PROs) and transferring results to the treating health professional in real time has the potential to improve patient well-being and cancer outcomes, this practice is not widespread. The aim of this study was to test the feasibility and acceptability of PROMPT-Care (Patient Reported Outcome Measures for Personalized Treatment and Care), a newly developed electronic health (eHealth) system that facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research. We developed an eHealth system in consultation with content-specific expert advisory groups and tested it with patients receiving treatment or follow-up care in two hospitals in New South Wales, Australia, over a 3-month period. Participants were recruited in clinic and completed self-report Web-based assessments either just before their upcoming clinical consultation or every 4 weeks if in follow-up care. A mixed methods approach was used to evaluate feasibility and acceptability of PROMPT-Care; data collected throughout the study informed the accuracy and completeness of data transfer procedures, and extent of missing data was determined from participants’ assessments. Patients participated in cognitive interviews while completing their first assessment and completed evaluation surveys and interviews at study-end to assess system acceptability and usefulness of patient self-management resources, and oncology staff were interviewed at study-end to determine the acceptability and perceived usefulness of real-time PRO reporting. A total of 42 patients consented to the study; 7 patients were withdrawn before starting the intervention primarily because of changes in eligibility. Overall, 35 patients (13 on treatment and 22 in follow-up) completed 67 assessments during the study period. Mean completeness of patient-reported data was 93%, with 100% accuracy of data transfer. Ten patients completed cognitive interviews, 28 completed evaluation surveys, and 14 completed evaluation interviews at study-end. PROMPT-Care patient acceptability was high—100% (28/28) reported the time to complete the Web-based assessments (average 15 min) as about right, most willing to answer more questions (79%, 22/28 yes), 96% (27/28) found the Web-based assessment easier or same as completing a paper copy, and they valued the self-management resources . Oncology staff (n=5) also reported high acceptability and potential feasibility of the system. Patients and oncology staff found the PROMPT-Care system to be highly acceptable, and the results suggest that it would be feasible to implement it into an oncology setting. Suggested modifications to the patient assessment survey, clinician access to the reports, and system requirements will be made as part of the next stage of large-scale testing and future implementation of the system as part of routine care. Australian New Zealand Clinical Trials Registry ACTRN1261500135294; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369299&isReview=true (Archived by WebCite at http://www.webcitation.org/6lzylG5A0).
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影响因子：
1.7
作者：
Girgis A;Delaney GP;Arnold A;Miller AA;Levesque JV;Kaadan N;Carolan MG;Cook N;Masters K;Tran TT;Sandell T;Durcinoska I;Gerges M;Avery S;Ng W;Della-Fiorentina S;Dhillon HM;Maher A
通讯作者：
Maher A
影响因子：
5.2
作者：
Pickard, Katherine E.;Wainer, Allison L.;Ingersoll, Brooke R.
通讯作者：
Ingersoll, Brooke R.
影响因子：
4.7
作者：
Kamal, Arif H.;Kavalieratos, Dio;Abernethy, Amy P.
通讯作者：
Abernethy, Amy P.
影响因子：
3.6
作者：
Girgis, Afaf;Stojanovski, Elizabeth;Lecathelinais, Christophe
通讯作者：
Lecathelinais, Christophe
影响因子：
45.3
作者：
Basch, Ethan;Deal, Allison M.;Schrag, Deborah
通讯作者：
Schrag, Deborah