Experience With the Routine Use of Electronic Patient-Reported Outcome Measures for Patients With Lung Cancer

Abstract

PURPOSE The Christie NHS Foundation Trust launched their electronic patient-reported outcome measures (ePROMs) service in January 2019 in the routine clinical setting. The lung cancer questionnaires consist of 14 symptom items, adapted from the Common Terminology Criteria for Adverse Events (version 5.0) and the EuroQol EQ-5D-5L quality-of-life (QoL) tool. Patients with lung cancer are invited to complete questionnaires assessing their symptoms and QoL using an online platform. METHODS The ePROM responses and clinical, pathologic, and treatment data for patients who completed the questionnaires between January 2019 and December 2020 were extracted from electronic medical records. The symptom and QoL scores of patients who completed baseline pretreatment ePROMs and also those who completed ePROMs pre- and postpalliative lung systemic anticancer therapy (SACT) or radical thoracic radiotherapy were evaluated. Pretreatment questionnaires were analyzed according to age, Eastern Cooperative Oncology Group performance status (ECOG PS), and Adult Comorbidity Evaluation-27 (ACE-27) comorbidity score. RESULTS One thousand four hundred eighty patients with lung cancer were included. There were no statistically significant differences in symptoms and QoL scores between age groups. Cough ( P = .006) and EQ-5D-5L mobility scores ( P = .006) were significantly worse for patients with an ECOG PS of 0-1. Dyspnea ( P = .035), hemoptysis ( P = .023), nausea ( P = .041), mobility ( P = .004), and self-care ( P = .0420) were significantly worse for those with higher ACE-27 scores (2-3 v 0-1). Palliative SACT was associated with a significant improvement in cough ( P < .001) and hemoptysis ( P = .025), but significantly negatively affected mobility ( P = .013). Patients receiving radical thoracic radiotherapy reported a significant improvement in hemoptysis ( P = .042) but worse pain ( P = .002) and fatigue ( P = .01). Other changes in symptom and QoL scores were not significant. CONCLUSION The symptoms and QoL reported at baseline and before and after both palliative SACT and radical thoracic radiotherapy are clinically relevant and meaningful. We have demonstrated that routine implementation of ePROMs into clinical practice is feasible and can inform clinical practice and future research.

A study demonstrating users’ preference for the adapted-REQUITE patient-reported outcome questionnaire over PRO-CTCAE® in patients with lung cancer

“…The EQ-5D quality of life questionnaire was also added to the questionnaire ( 37 ). A study conducted at The Christie by Crockett et al., including 1,480 patients with lung cancer who completed ePROMs questionnaires between January 2019 and December 2020, adds to the evidence supporting the feasibility and practicality of incorporating the REQUITE questionnaire in routine clinical practice ( 38 ). This service has been expanded beyond lung cancer to multiple disease sites.…”

Service Evaluation of MyChristie-MyHealth, an Electronic Patient-Reported Outcome Measure Integrated Into Clinical Cancer Care

“…Refer to Table 3 for a summary of objectives and recommendations made as a result of this study. The interviewed population is comparative with similar studies conducted at the Christie 22,36 and is representative of the wider population of ePROM completers and noncompleters.…”

Patients' experiences of engaging with electronic Patient Reported Outcome Measures (PROMs) after the completion of radiation therapy for breast cancer: a pilot service evaluation

“…While the feasibility of incorporating ePROMs after cancer treatment has recently been explored in other studies, 38 , 53 , 54 , 55 few publications have explored the use of ePROMs with patients post‐RT for breast cancer. Larger multicentre studies are needed to fully understand the potential benefits of ePROMs post‐RT for breast RT and other RT treatment sites.…”