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

Abstract

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.

Patient-reported outcome measures in oncology: a qualitative study of the healthcare professional’s perspective

“…Several oncological and non-oncological studies reported that the use of PROMs is associated with improved patientphysician communication, higher patient satisfaction, and improved symptom control. Results were most pronounced when feedback was provided to patient and healthcare professional (HCP) regarding the findings of the PROM [8][9][10].…”

Using Process Indicators to Monitor Documentation of Patient-Centred Variables in an Integrated Oncology and Palliative Care Pathway—Results from a Cluster Randomized Trial

“…The body of evidence regarding the benefit of using PROMs in a patient-centred context to improve patient outcomes is indisputable, with examples such as better communication between health care providers and patients, raised awareness and better management of symptoms, extended survival time, advising treatment decisions, and informing service delivery [ 2 , 18 , 19 , 20 , 21 , 22 , 23 ]. However, the use of PROMs to elicit patients’ views is not as widespread nor as systematic as necessary for provision of good quality care, not in general oncology, nor in palliative care [ 22 , 24 , 25 , 26 ]. In fact, reviews and meta-analyses show that 38% of cancer patients report moderate to severe pain (≥5 on 0–10 scales) and that one-third does not receive adequate pain medication [ 27 , 28 ].…”

Experiences of patients who developed oral mucositis during solid neoplasms treatment: a Ugandan qualitative study

“…However, studies with a qualitative angle are still few and in most cases have insufficient power. This makes it difficult to carry out more authoritative systematic reviews [ 15 , 16 ]. Given the fact that oral mucositis a continuum of gastro-intestinal mucositis is a dose /schedule modifying complication of chemotherapy [ 17 ], there is a need to identify areas of interventions that can reduce the suffering among patients undergoing cancer treatment.…”