CN12 - Integrating weekly symptom monitoring for patients with prostate cancer in radiation oncology: A prospective cohort study using electronic patient-reported outcomes

Background

Integrating active symptom monitoring of electronic patient-reported outcomes (ePROs) in a clinical workflow and engaging clinicians in acting on data is challenging. This study aimed to adapt weekly digital symptom monitoring into the prostate radiotherapy (RT) workflow and explore the impact of clinician engagement on patient compliance and satisfaction.

Methods

Patients with prostate cancer (PCa) referred for RT were eligible. Weekly ePROs were reported until four weeks following RT and weeks eight, 12 and 24. Clinicians monitored and used the ePROs for symptom management and ‘handled’ the response in the electronic patient record. In week four following RT, a validated Patient Feedback Form was distributed to assess patient satisfaction with ePRO, and a nurse-led follow-up (FU) was offered after responding. Health-related quality of life was measured with EQ-5D-5L.

Results

A consent rate of 91.5% (n=161) and an attrition rate of 5% resulted in 156 PCa patients included in the analyses (95% ePRO, 81% mean response rate). Non-participants tended to be older (mean age 72 vs 69 (p=0.010)) and have a poorer performance status (p<0.001). Patients reported ePROs improved communication and discussions with staff (91-93%) and gave them a greater sense of involvement (93%) (Table). Clinician engagement was high, with 93% of patients having all PROs handled. Among patients who chose to deselect FU (23%), a higher proportion had deteriorated EQ-VAS scores two months later (p=0.044) and fewer contacts with the department (p=0.045).

Conclusions

Integrating weekly ePROs in the radiotherapy workflow for PCa patients was feasible. When clinicians actively used PROs for symptom management, patients felt more involved and reported an improved quality of care and communication with the clinicians compared to their prior experiences. Further exploration of follow-up based on patient preference is warranted.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

P.K. Møller.

Funding

Novo Nordisk Foundation.

Disclosure

All authors have declared no conflicts of interest.