Electronic patient-reported outcomes from home in patients recovering from major gynecologic cancer surgery: A prospective study measuring symptoms and health-related quality of life

Abstract

Purpose-We previously reported on the feasibility of a Web-based system to capture patientreported outcomes (PROs) in the immediate postoperative period. The purpose of this study was to update the experience of these patients and assess patient and provider satisfaction and feedback regarding the system.Methods-This is a prospective cohort study of patients scheduled to undergo laparotomy for presumed gynecologic malignancy. Patients completed a Web-based Symptom Tracking and Reporting (STAR) questionnaire preoperatively and weekly during a 6-week postoperative period. Email alerts were sent to study nurses when concerning patient responses were entered. The patient and the nurse assessments of STAR's usefulness were measured via an exit survey.Corresponding Author: Dennis S. Chi, MD, Attending, Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, Professor of Surgery, Weill Cornell Medical College, 1275 York Ave, New York, NY 10065, USA, Phone: +1 212-639-5016, Fax: +1 212-717-3095, chid@mskcc.org. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptResults-The study enrolled 96 eligible patients. Of these, 71 patients (74%) completed at least four of seven total sessions. Of the patients who completed the exit satisfaction survey, 98% found STAR easy to use; 84% found it useful; and 82% would recommend it to other patients. Despite positive feedback from patients, clinical personnel found that the STAR system increased their current workload without enhancing patient care.Conclusions-Application of an electronic program for PROs in those recovering from major gynecologic cancer surgery is feasible, and acceptable to most patients. While most clinicians did not find STAR clinically helpful, the majority of patients reported a positive experience with the system and would recommend its use. The program helped many patients feel more empowered in their postoperative recovery.

Patient-Reported Toxicities During Chemotherapy Regimens in Current Clinical Practice for Early Breast Cancer

“…Standardized reporting is now available through the National Cancer Institute's Patient-Reported Outcomes-CTCAE (PRO-CTCAE) scales [10][11][12][13]. Efforts are underway to integrate PRO-CTCAE measurement into clinical trials [14][15][16][17][18][19], and interest is growing in the implementation and utilization of patient-reported symptom monitoring in patient-centered clinical practice [20][21][22][23][24][25][26][27][28][29]. Like CTCAE, the focus of PRO-CTCAE is continuous symptom monitoring throughout chemotherapy, not just at the beginning and end of chemotherapy.…”

An Environment for Guidelinebased Decision Support Systems for Outpatients Monitoring

“…Compared to the conventional paperpencil approach, ePROs are more efficient and also increase data quality [8]. Various technologies including speech recording [9] and web based forms [10] have been used as effective means for acquiring ePROs with promising results. As for the best way of collecting ePROs, we observe that the "Digital in 2016" report shared by the global agency "We Are Social" in January 2016 stated that 51% of adults across 30 surveyed countries reported owning a smartphone, with a peak in developed countries.…”

Web-Based Patient-Reported Outcomes Using the International Consortium for Health Outcome Measurement Dataset in a Major German University Hospital: Observational Study (Preprint)

“…One crucial point in establishing a successful digital program is to explain and educate all health care providers who will be involved in the collection of PROs about the purpose and benefit of PRO. While there is increasing interest and knowledge about PRO measurement there are concerns regarding workflow, increase in workload due to the additional measurements as well as data overload and creation of additional needs [17] [18] [19]. These findings are mirrored in our low patient accrual data in the first six months after implementation.…”