Objective:We implemented routine daily electronic monitoring of patient-reported outcomes (PROs) for 10 days after discharge after ambulatory cancer surgery, with alerts to clinical staff for worrying symptoms. We sought to determine whether enhancing this monitoring by adding immediate automated normative feedback to patients regarding expected symptoms would further improve the patient experience.Summary of Background Data:PRO monitoring reduces symptom severity in cancer patients. In ambulatory cancer surgery, it reduces potentially avoidable urgent care center (UCC) visits, defined as those UCC visits without readmission.Methods:Patients undergoing ambulatory cancer surgery (n = 2624) were randomized to receive standard PRO monitoring or enhanced feedback. The primary study outcome was UCC visits without readmission within 30 days; secondary outcomes included patient anxiety and nursing utilization.Results:There was no significant difference in the risk of a potentially avoidable UCC visit [1.0% higher in enhanced feedback, 95% confidence interval (CI) -0.2–3.1%; P = 0.12]. There were similarly no significant differences in UCC visits with readmission or readmission overall (P = 0.4 for both). Patients randomized to enhanced feedback demonstrated a quicker reduction in anxiety (P < 0.001) and required 14% (95% CI 8–19%; P < 0.001) and 10% (95% CI 5–16%, P < 0.001) fewer nursing calls over 10 and 30 days postoperatively.Conclusions:Providing patients with feedback about symptom severity during recovery from ambulatory cancer surgery reduces anxiety and nursing workload without affecting UCC visits or readmissions. These results support wider incorporation of normative feedback in systems for routine PRO monitoring.
The influence of racial differences on perceived psychological distress and impairment was examined with a nationally representative sample of Black and White Latinxs. The study sample was selected from multiple years of the National Health Interview Survey and included 30,519 self-identified Black and White Latinxs between the ages of 26 and 64 years. Results indicated that Black Latinxs reported higher levels of psychological distress—a statistically significant difference—compared to White Latinxs after accounting for demographic (age, gender, marital status, and nativity) and socioeconomic status (level of education and health insurance) indicators. Results also indicated that Black and White Latinxs did not differ on impairment associated with perceived psychological distress. The practice of aggregating Black and White Latinxs obscures the racialized experiences reported by Black Latinxs and associated higher levels of psychological distress. Implications and future directions are discussed.
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