Implementing Patient-Reported Outcome Measures in Clinical Breast Cancer Care: A Systematic Review

Egdom, Laurentine S. E. van; Oemrawsingh, Arvind; Verweij, Lotte; Lingsma, Hester F.; Koppert, Linetta B.; Verhoef, Cornelis; Klazinga, Niek; Hazelzet, Jan A.

doi:10.1016/j.jval.2019.04.1927

Cited by 95 publications

(97 citation statements)

References 70 publications

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“…There is wide variation in how PROMs/PREMs are implemented [15,16] and in the resulting impact on processes and outcomes of care [1,2,5,6]. Prior research has documented the limited uptake of PROMs/PREMs and barriers to their implementation in routine care settings [17][18][19][20][21]. Implementation science (IS) offers a potential way forward, but its application has been limited for PROMs/PREMs.…”

Section: Introductionmentioning

confidence: 99%

Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings

Ahmed²,

et al. 2020

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Purpose Patient-reported outcome and experience measures (PROMs/PREMs) are well established in research for many health conditions, but barriers persist for implementing them in routine care. Implementation science (IS) offers a potential way forward, but its application has been limited for PROMs/PREMs. Methods We compare similarities and differences for widely used IS frameworks and their applicability for implementing PROMs/PREMs through case studies. Three case studies implemented PROMs: (1) pain clinics in Canada; (2) oncology clinics in Australia; and (3) pediatric/adult clinics for chronic conditions in the Netherlands. The fourth case study is planning PREMs implementation in Canadian primary care clinics. We compare case studies on barriers, enablers, implementation strategies, and evaluation. Results Case studies used IS frameworks to systematize barriers, to develop implementation strategies for clinics, and to evaluate implementation effectiveness. Across case studies, consistent PROM/PREM implementation barriers were technology, uncertainty about how or why to use PROMs/PREMs, and competing demands from established clinical workflows. Enabling factors in clinics were context specific. Implementation support strategies changed during pre-implementation, implementation, and post-implementation stages. Evaluation approaches were inconsistent across case studies, and thus, we present example evaluation metrics specific to PROMs/PREMs. Conclusion Multilevel IS frameworks are necessary for PROM/PREM implementation given the complexity. In cross-study comparisons, barriers to PROM/PREM implementation were consistent across patient populations and care settings, but enablers were context specific, suggesting the need for tailored implementation strategies based on clinic resources. Theoretically guided studies are needed to clarify how, why, and in what circumstances IS principles lead to successful PROM/ PREM integration and sustainability.

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Section: Introductionmentioning

confidence: 99%

Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings

Ahmed²,

et al. 2020

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“…Completing PROMs may be stressful and time-consuming for patients. A known barrier of using PROMs in daily care is the amount of extra administrative efforts experienced by health care professionals (HCPs) [20][21][22]. A properly functioning IT system could solve some of these extra efforts, yet this is often lacking [23].…”

Section: Introductionmentioning

confidence: 99%

Patient outcomes, patient experiences and process indicators associated with the routine use of patient-reported outcome measures (PROMs) in cancer care: a systematic review

Graupner

Kimman

Mul

et al. 2020

Support Care Cancer

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Purpose In current cancer care, there is a growing debate about the value of using patient-reported outcome measures (PROMs) in daily clinical follow-up. A systematic review of the literature was conducted to assess the evidence of the effectiveness of the routine use of PROMs in daily cancer care in terms of patient outcomes, patient experiences and process indicators and to identify the effect of giving feedback about PROM findings to patients and/or health care professionals (HCPs). Methods A systematic search was performed. Studies were eligible for inclusion when they (1) used a PROM as an intervention, with or without feedback to patients and/or HCPs, compared with not using a PROM, and (2) used a PROM as an intervention with feedback to patients and/or HCPs, compared with using a PROM without giving feedback to patients and/or HCPs. Results After screening of 8341 references, 22 original studies met the inclusion criteria. Most studies found a positive effect on survival, symptoms, HRQoL and patient satisfaction. In general, using feedback to patient and/or HCPs about the PROM results led to better symptom control, HRQoL, patient satisfaction and patient-doctor communication. The majority of included studies had insufficient power to detect significant differences in the outcomes assessed. Conclusion This review shows that predominantly positive findings were found in the use of a PROM in daily cancer care. Additionally, more positive effects were seen when feedback is provided to patient and/or health care professionals, and it is thus highly recommended that this is always done.

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“…A recent systematic review of PROM administration methods in breast cancer found positive impacts from the systematic collection of PROMs, as well as highlighting a need for additional reporting of PROM collection frequency and methods. 18 More broadly, published studies regarding satisfaction with breast cancer surgery are limited by small sample size, limited representativeness of institutions and surgeons, and the use of generic surveys not specifically designed for this population. 20 Currently, the UK collects breast cancer PROs on a large scale as a national audit tool 21 ; more recently the Organisation for Economic Co-operation and Development (OCED) has started international comparative work on breast cancer PROMs, involving international sites in data collection.…”

Section: Open Accessmentioning

confidence: 99%

Systematic and continuous collection of patient-reported outcomes and experience in women with cancer undergoing mastectomy and immediate breast reconstruction: a study protocol for the Tuscany Region (Italy)

et al. 2021

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IntroductionMonitoring how patients feel and what they experience during the care process gives health professionals data to improve the quality of care, and gives health systems information to better design and implement care pathways. To gain new insights about specific gaps and/or strengths in breast cancer care, we measure patient-reported outcomes (PROs) and patient-reported experiences (PREs) for women receiving immediate breast reconstruction (iBR).Methods and analysisProspective, multicentre, cohort study with continuous and systematic web-based data collection from women diagnosed with breast cancer, who have an indication for iBR after mastectomy treated at any Breast Unit (BU) in Tuscany Region (Italy). Patients are classified into one of two groups under conditions of routine clinical practice, based on the type of iBR planned (implant and autologous reconstruction). Patient-reported information are obtained prior to and after surgery (at 3-month and 12-month follow-up). We estimate that there are around 700 annual eligible patients.Descriptive analyses are used to assess trends in PROs over time and differences between types of iBR in PROs and PREs. Additionally, econometric models are used to analyse patient and BU characteristics associated with outcomes and experiences. PREs are evaluated to assess aspects of integrated care along the care pathway.Ethics and disseminationThe study has been reviewed and obtained a nihil obstat from the Tuscan Ethics Committees of the three Area Vasta in 2017. Dissemination of results will be via periodic report, journal articles and conference presentations.

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Implementing Patient-Reported Outcome Measures in Clinical Breast Cancer Care: A Systematic Review

Cited by 95 publications

References 70 publications

Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings

Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings

Patient outcomes, patient experiences and process indicators associated with the routine use of patient-reported outcome measures (PROMs) in cancer care: a systematic review

Systematic and continuous collection of patient-reported outcomes and experience in women with cancer undergoing mastectomy and immediate breast reconstruction: a study protocol for the Tuscany Region (Italy)

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