Use of Patient-Reported Outcomes to Improve Care Delivery in Cancer Patients

Use of Patient-Reported Outcomes to Improve Care Delivery in Cancer Patients

Introduction

At the point of care, collecting electronic patient-reported outcome has served as a feasible and more consistent method of providing reliable details than clinicians’ reports. Patient-reported outcome is more effective in providing specific details regarding the patient experience. The significance of in-depth information in assisting clinicians’ choice of approach in care provision cannot be overlooked. In essence, particular patient details enable nurses and physicians to comprehend patient prognosis, specific complications and select effective measures to manage the patient’s condition, culminating in improved health outcomes. This paper reviews several articles pertaining to application of patient-reported outcomes to improve care delivery in cancer patients.

ORDER NOW FOR A SIMILAR ESSAY CUSTOMIZED TO YOUR NEEDS

LeBlanc, T. W., & Abernethy, A. P. (2017). Patient-reported outcomes in cancer care—hearing the patient voice at greater volume. Nature Reviews Clinical Oncology14(12), 763-772. https://doi.org/10.1038/nrclinonc.2017.153

Documenting patient-reported outcomes enables the care provider to directly measure the patient experience. Recent years have witnessed increasing application of PROs in measuring quality of health care among various providers. Whereas PROs were previously utilized in research processes, current reliable studies reveal that electronic data acquisition in PROs yield more quality results than clinician-documented data (LeBlanc & Abernethy, 2017). This study reveals that incorporating electronic patient-reported outcomes remarkably boosted the quality of care delivery among cancer patients. Limitations of wide implementation of ePROs comprise of challenges of PRO data acquisition integration into electronic medical record systems as well as the clinical workflows. Whereas ePRO data documentation should augment care delivery quality to cancer patients, specifically skilled professionals and suitable policies ought to be implemented, culminating in increased success of ePROs in routine practice.

According to the study, the added advantages of ePROs include providing data of research-quality, improving learning of health-care systems and advancing innovation by implementing “big data” initiatives. The ePROs provide the patients’ voice, enabling more comprehensive knowledge of patient conditions and appropriate interventions. Nonetheless, ePROs fall short of big data initiatives at present, which could be alleviated by providing data standardization measures. Consistent collection of ePROs results in improved care quality, leading to more desirable patient outcomes.

Yang, L. Y., Manhas, D. S., Howard, A. F., & Olson, R. A. (2018). Patient-reported outcome use in oncology: A systematic review of the impact on patient-clinician communication. Supportive Care in Cancer26(1), 41-60. https://doi.org/10.1007/s00520-017-3865-7

The article describes a systematic review of credential literature reporting on outcomes of PROs utilization as an intervention tool instead of experimentation tool. The authors elaborate on the role of PROs in filling the void between patient experience and clinician comprehension. They identified the means via which PROs enhance relay of information from the patient to the clinician within the adult oncology clinic. The study measures comprised of PRO application as an intervention tool, cancer patients and survivors and analysis of patient-clinician communication. Out of the 610 unique records selected, 43 articles satisfied the inclusion and exclusion criteria. The review revealed various mechanisms via which PROs facilitated communication between the patient and clinician, including improving awareness of symptoms, triggering discussions, simplifying consultations and enhancing multi-disciplinary communication among care providers (Yang et al., 2018). The authors identified barriers to PRO implementation as technical complications that limit its provision to patients and filling, non-compliance owing to forgetfulness or limited incentives and PROs that fall short of meeting specific patient needs. Factors to promote PRO implementation include increasing awareness of PRO use through patient education, applying more patient-centered PROs and supplying clinicians with easily comprehensible data summaries from patients.

Zhang, B., Lloyd, W., Jahanzeb, M., & Hassett, M. J. (2018). Use of patient-reported outcome measures in quality oncology practice initiative–registered practices: Results of a national survey. Journal of Oncology Practice14(10), e602-e611. https://doi.org/10.1200/jop.18.00088

For cancer patients, patient-reported outcomes are linked to improved quality of life and higher survival rates. Nonetheless, PROs application is a new concept with limited scope of knowledge on practices of collection, measuring and challenges pertinent to its application. In this article, the authors surveyed Quality Oncology Practice Initiative-credible practices to comprehend the existing PROs implementation and to discover where additional support may be required. The collectors of PROs were prompted with the questions of their views, practices and challenges in the implementation while non collectors were questioned on their interest in and seeming barriers to data acquisition. Whereas the majority of respondents implied that PROs collection was a high priority, significantly fewer actually collected PROs. Also, majority of collectors were associated with medical centers or hospitals and utilized electronic health records. The results revealed that more patients per week were noted for collectors of PROs than non-collectors while the collector PROs focused on diverse subjects, ranging from patient symptoms, distresses and experience/satisfaction (Zhang et al., 2018). The challenges of implementation for collectors resembled for non-collectors, including absent patient cooperation in questionnaire filling, unreliable staff support and inadequate PRO integration into electronic health records.

Dirven, L., Armstrong, T. S., Blakeley, J. O., Brown, P. D., Grant, R., Jalali, R., Leeper, H., Mendoza, T., Nayak, L., Reijneveld, J. C., Le Rhun, E., Walbert, T., Weller, M., Wen, P. Y. & Taphoorn, M. J. (2018). Working plan for the use of patient-reported outcome measures in adults with brain tumours: A Response Assessment in Neuro-Oncology (RANO) initiative. The Lancet Oncology19(3), e173-e180. https://doi.org/10.1016/s1470-2045(18)30004-4

The Response Assessment in Neuro-Oncology-Patient-Reported Outcome is a multidisciplinary body traversing diverse nations and providing information on application of patient-reported outcomes measures in clinical trials and practice among adult patients having brain tumors. The authors elaborate in detail how findings from conventional outcome markers and PROs are applied to improve understanding among policy makers, researchers, physicians and patients in health care provision approaches and strategies. Whereas previous approaches in oncology centered on guidelines directing collection, analysis, interpretation and reporting of PRO data, the authors propose wider application of the PRO contents. In particular, appropriate PRO instruments such as the content validity and alignment with the research question provide more comprehensive outcomes among patients (Divern et al., 2018). Well-articulated PROs are more reliable and provide high-value evidence. Concerned parties could apply specific measures to improve the value of evidence from PROs. The specific PRO measures could be attained from previous neuro-oncological studies to determine which factors could be applied to improve patient experience and outcome in health care settings. Moreover, this approach could open up a new dimension into assessment of therapeutic values in brain tumor patients.

Conclusion

In a nutshell, the significance of in-depth information in assisting clinicians’ choice of approach in care provision cannot be overlooked. Reliable sources reveal that PROs provide particular patient details that are inadequate in clinician documentation. The in-depth information enables nurses and physicians to comprehend patient prognosis, specific complications and select effective measures to manage the patient’s condition, culminating in improved health outcomes. Therefore, patient reported outcomes provide the patient voice which enables the provider to comprehend more deeply the patient symptoms, distress and satisfaction. Notwithstanding the benefits of PROs in cancer care, their implementation is limited by several factors, among them, technical limitations, unmet patient needs in PROs, inadequate skills in handling PRO data and incompatibility between PROs and EMRs. Alleviating the challenges through increasing awareness of PROs among patients and health workers, incorporating PROs into EMRs and designing PROs to meet specific patient needs would remarkably boost their success.

Use of Patient-Reported Outcomes to Improve Care Delivery in Cancer Patients References

Dirven, L., Armstrong, T. S., Blakeley, J. O., Brown, P. D., Grant, R., Jalali, R., Leeper, H., Mendoza, T., Nayak, L., Reijneveld, J. C., Le Rhun, E., Walbert, T., Weller, M., Wen, P. Y. & Taphoorn, M. J. (2018). Working plan for the use of patient-reported outcome measures in adults with brain tumours: a Response Assessment in Neuro-Oncology (RANO) initiative. The Lancet Oncology19(3), e173-e180. https://doi.org/10.1016/s1470-2045(18)30004-4

LeBlanc, T. W., & Abernethy, A. P. (2017). Patient-reported outcomes in cancer care—hearing the patient voice at greater volume. Nature Reviews Clinical Oncology14(12), 763-772. https://doi.org/10.1038/nrclinonc.2017.153

Yang, L. Y., Manhas, D. S., Howard, A. F., & Olson, R. A. (2018). Patient-reported outcome use in oncology: a systematic review of the impact on patient-clinician communication. Supportive Care in Cancer26(1), 41-60. https://doi.org/10.1007/s00520-017-3865-7

Zhang, B., Lloyd, W., Jahanzeb, M., & Hassett, M. J. (2018). Use of patient-reported outcome measures in quality oncology practice initiative–registered practices: Results of a national survey. Journal of Oncology Practice14(10), e602-e611. https://doi.org/10.1200/jop.18.00088