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Abstract
BACKGROUND
Neuro-oncology (NOC) patients experience various symptoms from disease and treatment which are deleterious to function and quality of life (QOL). Evidence demonstrates the use of electronic patient-reported outcomes (ePROs) improves health-related QOL, mental functioning, patient-provider communication, and overall survival. Despite this knowledge, uptake across cancer services has been slow. In this pilot study, we sought to understand the utility of an electronic symptom monitoring platform (ESMP) in this population.
METHODS
We implemented an ESMP at a NOC practice and conducted a preliminary analysis of ePROs over 7-month period. Patients were prompted to report their symptoms at least 3 times/week through multiple-choice questions targeting 19 distinct symptoms and their severity (tiered 1-4). The care team was automatically notified through the electronic medical record predefined symptom severities.
RESULTS
During a 7-month period, 28 neuro-oncology patients were enrolled and monitored for a total of 660.7 patient-weeks or an average of 23.6 weeks per patient. In total, 314 questionnaires were completed; each patient completed 0.6 per week on average. We found questionnaire compliance to be the highest initially, declining in subsequent weeks. Symptoms were reported in 42.8% of questionnaires; the most frequent of which were peripheral neuropathy (16.6%), fatigue (11.5%) and headache (10.5%). Alerts were sent to the care team for 103 (32.8%) questionnaires, 38 resulted in additional interventions for the patient.
CONCLUSION
Our results support the hypothesis that technology-enabled integration of ePROs enables monitoring followed by automated alerts and customized responses to NOC patients. We note that peak usage was at the beginning of active treatment which occurred concurrently with onboarding. Opportunities and challenges involve the continuous promotion of patient engagement and optimization of workflow to encourage discussions and utilization. Future work also includes determining if this platform can lead to improved clinician efficiency and patient outcomes in this patient population.