Improving Outcomes in Patients with CRC: The Role of Patient Reported Outcomes—An ESDO Report

Abstract

Colorectal cancer is one of the most commonly diagnosed cancers worldwide and nearly half of patients will develop metastatic disease at some point during the course of their disease. The goal of anticancer therapy in this context is to extend survival, while trying to maximise the patient’s health-related quality of life. To this end, we need to understand how to incorporate patient-reported outcomes into clinical trials and routine practice to accurately assess if treatment strategies are providing clinical benefit for the patient. This review reflects the proceedings of a 2016 European Society of Digestive Oncology workshop, where the authors discussed the use of patient-reported outcomes to measure health-related quality of life when evaluating treatment during the management of colorectal cancer. A summary of the challenges associated with implementing patient-reported outcomes in clinical trials is provided, as well as a review of the current clinical evidence surrounding patient-reported outcomes in metastatic colorectal cancer.

Patient reported outcomes in oncology: changing perspectives—a systematic review

“…Indeed, most studies reviewed the evidence that the communication processes in health systems are complex. PROs incorporation in oncology improves clinical practice [ 42 , 47 , 92 ], structures the communication, develops effective communication tools and communication skills training [ 93 – 95 ], and contributes to the delivery of effective oncology high-quality care [ 34 , 39 , 76 ], improved patient-safety and patient satisfaction, and reduces patient anxiety [ 39 , 42 , 48 , 49 , 65 – 67 , 77 , 88 ].…”

“…identified key areas of improvement and confirmed that well-conducted and reported prognostic model studies with a PRO predictor have great potential to improve healthcare delivery [ 38 ]. The physical functioning, global health and QoL domains were consider significant prognostic factors (prognosticators) and several domains have been evidenced [ 39 , 40 , 43 ] including patient-reported functional scores [ 37 , 42 , 60 , 61 , 63 , 68 ], patient-reported symptom interference [ 38 , 49 , 59 , 62 , 65 , 66 ], patient-reported depression [ 96 ], or patient-reported fatigue [ 67 , 69 ].…”

“…Stepped care models design based on PROs data collection can reflect the patient’ disease pathway, allowing the development of appropriate and sustainable long-term follow-up models for cancer survivors, foreseeing supported self-management and shared care (supportive care, epidemiological data, groups screening) [ 5 , 32 , 34 , 36 , 37 , 40 , 41 , 43 , 47 , 49 , 54 , 56 , 57 , 65 , 97 ]. Automated algorithms may support risk-stratified guideline-informed care [ 4 , 31 , 38 , 42 , 47 , 50 , 52 , 53 ].…”

“…The present study reports that PROs can capture patient’s essentials on disease pathway. They are crucial at baseline and follow-up stages and consistently consider them in research and clinical practice is a major concern for future in health systems [ 31 – 34 , 37 – 42 , 50 , 51 , 59 – 63 , 65 , 66 , 69 , 77 , 88 , 93 , 94 , 97 – 99 ].…”

Quality Assurance, Metrics, and Improving Standards in Rectal Cancer Surgery in the United States

“…These measure are known as patient reported outcomes (PROs). PROs allow for early detection of distress in a patient, provides a valuable opportunity for patients to be heard, and allows for interventions to be directed toward specific symptoms (43). Thanks to new psychometric techniques and electronic platforms, much of this data can now be easily collected.…”