CN37 - Use of pictograms (picto) for outpatients treated for cancer and monitored by telehealth: A feasibility and proof of concept study

Background

Use of patient-reported outcomes (PRO) in routine have shown several benefits in terms of cancer patients care. Patients’ low health literacy is a barrier to the use of PRO. In this context the addition of picto to the questionnaires could compensate and enable more patients to benefit from them. The aim of this study is to assess the adherence and the helpfulness of picto from the patients’ perspective.

Methods

Twelve picto were created by the hospital's disability mission. During 9 days in January 2024, all outpatients with a solid cancer undergoing chemotherapy at the Mondor Teaching Hospital, France, were invited to test the picto. Pts were asked whether the picto was helpful or not to understand the ePRO question. Unsupervised hierarchical clustering was used to detect patterns of pts or picto with differential picto answers data distributions. Isolated clusters were then described.

Results

We enrolled 99 pts : 52 females, 64 yrs median age (interquartile range (IQR), 54-71), 49 had gastro-intestinal cancer, 66 pts had metastases.Helpfulness of picto was analysed (n=1188 answers) : picto were considered as helpful in 70% (n=815), picto did not help in 27% (n=322) and picto put them in trouble in 3% (n=32), data was missed for 19 responses. The clustering highlighted 2 groups of picto: 4 picto were not convincing: taste, appetite, pain and case contact. For the 8 other picto, (cough, shortness of breath, asthenia, fatigue, skin rash, vomiting, diarrhea and fever) helpfulness was higher in 79%.3 patient categories emerged from the clustering: group 1 (12%) of pts were not helped by the picto (more female, younger age and mostly breast cancer). Group 2 ( 40%) who finds the picto globally helpful. Group 3 (48%) is a mixed of pts who can be helped but also put in difficulty. No major characteristics difference was observed between these groups, except for age and primary tumor site.

Conclusions

Using picto for outpatients treated for cancer and followed by telehealth can help a majority of patients. 8 picto have globally helped patients, and 4 need to be redrawn. Additional research is needed to better characterize the populations that would better benefit from the use of picto.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.