Use of patient-reported outcomes to measure symptoms and health related quality of life in the clinic.
AffiliationMRCP, University of Leeds, UK.
MetadataShow full item record
AbstractThere is increasing interest in the use of patient-reported outcomes (PROs) in routine practice in cancer care to measure symptoms and health related quality of life (HRQOL). PROs are designed to capture the patient's perspective of their care and treatment, and complement the traditional clinical outcomes of survival and toxicity assessment. Integrating routine collection and feedback of PROs has been found to improve care for patients on both an individual level, through improved communication and management of symptoms, and at an organizational level, by enabling aggregation of data to compare performance. This article reviews the benefits and challenges of introducing patient-reported assessments into routine clinical practice. Methods for choosing a questionnaire; collection and presentation of results; timing and frequency of administration as well as clinician training methods to aid the ability of clinicians to integrate the use of PROs into their own practice are described. Electronic PRO capture and integration with electronic health records seems to provide the most effective method for seamless integration into existing patient care pathways. Case studies from our own practice illustrate the issues raised. Electronic methods enabling immediate collection, scoring and interpretation of the data, as well as real-time data capture, email alert systems and individualized, online self-management advice may enable severe symptoms to be managed in a more timely manner. Evaluation methods are described to establish the effectiveness of the PRO intervention. Engaging stakeholders throughout the process of initial consultation and development, during delivery and evaluation is key to success. Future work needs to focus on the effectiveness of PROs in longer-term follow-up of patients in routine care and the relationship between the PRO severity grading and clinician severity grading using the Common Terminology Criteria of Adverse Events (CTCAE).
CitationUse of patient-reported outcomes to measure symptoms and health related quality of life in the clinic. 2014: Gynecol Oncol
- Integrating the use of patient-reported outcomes for both clinical practice and performance measurement: views of experts from 3 countries.
- Authors: Van Der Wees PJ, Nijhuis-Van Der Sanden MW, Ayanian JZ, Black N, Westert GP, Schneider EC
- Issue date: 2014 Dec
- How has the impact of 'care pathway technologies' on service integration in stroke care been measured and what is the strength of the evidence to support their effectiveness in this respect?
- Authors: Allen D, Rixson L
- Issue date: 2008 Mar
- The role of technical advances in the adoption and integration of patient-reported outcomes in clinical care.
- Authors: Jensen RE, Rothrock NE, DeWitt EM, Spiegel B, Tucker CA, Crane HM, Forrest CB, Patrick DL, Fredericksen R, Shulman LM, Cella D, Crane PK
- Issue date: 2015 Feb
- Building an electronic health record integrated quality of life outcomes registry for spine surgery.
- Authors: Azad TD, Kalani M, Wolf T, Kearney A, Lee Y, Flannery L, Chen D, Berroya R, Eisenberg M, Park J, Shuer L, Kerr A, Ratliff JK
- Issue date: 2016 Jan