Clinical Utility and User Perceptions of a Digital System for Electronic Patient-Reported Symptom Monitoring During Routine Cancer Care: Findings From the PRO-TECT Trial
Clinical Utility and User Perceptions of a Digital System for Electronic Patient-Reported Symptom Monitoring During Routine Cancer Care: Findings From the PRO-TECT Trial
复制标题
DOI：
10.1200/cci.20.00081
复制
发表时间：
2020-10-28
影响因子：
4.2
通讯作者：
Dueck, Amylou C.
中科院分区：
文献类型：
--
作者：
Basch, Ethan;Stover, Angela M.;Dueck, Amylou C.
在常规肿瘤学实践中，对实施用于远程监测患者症状的数字系统的兴趣越来越大。这些systems.METHODS PRO-TECT是一项多中心试验，评估在美国社区肿瘤实践（ClinicalTrials.gov标识符：NCT 03249090）接受治疗的晚期和转移性癌症成人中实施电子患者报告结局（ePRO）。每周通过网络或自动电话系统管理来自不良事件通用术语标准（PRO-CTCAE）患者报告结局版本的问题，并提醒护士出现重度或恶化症状。为了引起用户的反馈，调查参与患者和临床医生。结果在496例患者在26个做法，大多数发现系统和问题容易理解（95%），易于使用（93%），并与他们的护理（91%）。大多数患者报告说，PRO信息被他们的临床医生用于护理（70%），改善了与临床医生的讨论（73%），使他们感觉更能控制自己的护理（77%），并将该系统推荐给其他患者（89%）。在单变量和多变量分析中，大多数患者反馈问题的评分与每周PRO完成率显著正相关。在57名护士中，大多数人报告PRO信息有助于临床记录（79%），提高患者讨论的效率（84%），对患者护理有用（75%）。在39名肿瘤学家中，大多数发现PRO信息有用（91%），65%使用PRO有时或经常指导患者讨论，65%使用PRO有时或经常做出治疗决策。结论这些研究结果支持在常规癌症护理中实施数字化PRO监测系统（包括PRO-CTCAE）的临床实用性和价值。(c)2020年美国临床肿瘤学会
PURPOSE There is increasing interest in implementing digital systems for remote monitoring of patients' symptoms during routine oncology practice. Information is limited about the clinical utility and user perceptions of these systems.METHODS PRO-TECT is a multicenter trial evaluating implementation of electronic patient-reported outcomes (ePROs) among adults with advanced and metastatic cancers receiving treatment at US community oncology practices (ClinicalTrials.gov identifier: NCT03249090). Questions derived from the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) are administered weekly by web or automated telephone system, with alerts to nurses for severe or worsening symptoms. To elicit user feedback, surveys were administered to participating patients and clinicians.RESULTS Among 496 patients across 26 practices, the majority found the system and questions easy to understand (95%), easy to use (93%), and relevant to their care (91%). Most patients reported that PRO information was used by their clinicians for care (70%), improved discussions with clinicians (73%), made them feel more in control of their own care (77%), and would recommend the system to other patients (89%). Scores for most patient feedback questions were significantly positively correlated with weekly PRO completion rates in both univariate and multivariable analyses. Among 57 nurses, most reported that PRO information was helpful for clinical documentation (79%), increased efficiency of patient discussions (84%), and was useful for patient care (75%). Among 39 oncologists, most found PRO information useful (91%), with 65% using PROs to guide patient discussions sometimes or often and 65% using PROs to make treatment decisions sometimes or often.CONCLUSION These findings support the clinical utility and value of implementing digital systems for monitoring PROs, including the PRO-CTCAE, in routine cancer care. (c) 2020 by American Society of Clinical Oncology