Patient-targeted education (ePRO-E) to increase ePRO intent within an Alliance clinical trial (A221805-SI1)

Abstract

Background The Patient Cloud ePRO app was adopted by the National Cancer Institute National Clinical Trials Network (NCTN) to facilitate capturing electronic patient-reported (ePRO) outcome data, but use has been low. The study objectives were to test whether a patient-targeted ePRO educational resource (ePRO-E) would increase ePRO intent (number of users) and improve data quality (high quality: ≥80% of the required surveys submitted) within an ongoing NCTN study. Methods The ePRO-E intervention, a patient-targeted educational resource (written material and 6-minute animated YouTube video), was designed to address ePRO barriers. ePRO intent and data quality were compared between two groups (N = 69): a historical control group and a prospectively recruited intervention group exposed to ePRO-E. Covariates included technology attitudes, age, sex, education, socioeconomic status, and comorbidity. Results Intervention group ePRO intent (78.8%) was significantly higher than historical control group intent (47.1%) (p = .03). Patients choosing ePRO vs paper surveys had more positive/higher technology attitudes scores (p = .03). The odds of choosing ePRO were 4.7 times higher (95% CI; 1.2–17.8) (p = .02) among intervention group patients and 5.2 times higher (95% CI; 1.3-21.6) (p = .02) among patients with high technology attitudes scores, after controlling for covariates. However, the 80% submission rate (percentage submitting ≥ 80% of required surveys) in the ePRO group (30.6%) was significantly lower than in the paper group (57.9%) (p = .05). Conclusions ePRO-E exposure increased ePRO intent. High technology attitudes scores were associated with ePRO selection. Since the ePRO survey submission rate was low, additional strategies are needed to promote high quality data submission.