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Table 5 Summary of Earlier Relevant SLR of Implementation of PRO in Cancer Clinical Care

From: Exploring the implementation of patient-reported outcome measures in cancer care: need for more real-world evidence results in the peer reviewed literature

Review Reference Review goal Databases + Search strategy # References Screened # Articles reviewed Timeframe Major Conclusions
Howell et al. 2015 [32] To identify PROMs used in routine cancer clinical practice, their impact on patient, provider, and system outcomes, and the implementation factors influencing uptake. Ovid Medline CINAHL PsycINFO Grey Literature 3297 30 2003–2013 The EORTC QLQ30 was the most commonly used PRO Use of PROMs for screening for emotional distress, unmet supportive care needs, or social difficulties Wide variety of PROMs were used with little standardization across studies PROMs implementation improves communication about symptoms and QoL More attention needs to be paid to complexity of implementation and interpretation of PROMS
King et al. 2016 [33] To examine the use and impact of using quality of life measures on health care of cancer patients within a clinical setting, particularly those with brain cancer. PubMed, EMBASE, Cochrane (SR & Trials), Web of Science [SCI]) Grey literature 18,483 19 2000–2015 QoL data may improve patient–physician communication, increase discussion of emotional functioning in particular. Scarcity of data on actions/medical decisions.
Chen et al. 2013 [31] To provide a comprehensive review update including all relevant quantitative studies investigating the effectiveness of routine PRO collection in cancer patients. NR Two-step search strategy building on existing reviews 1182 27 2000–2011 Strong evidence: PROs enhances patient-provider communication, improves patient satisfaction. Moderate evidence: PRO improves monitoring of treatment response and the detection of unrecognized problems. Weak Evidence: Changes to patient management, improved health outcomes No evidence: changes to patient health behavior, quality improvement, increased transparency, accountability, public reporting and better health care system performance
Jensen et al. 2013 [93] To identify existing PRO systems and their administration of PRO assessments, integration of information into the clinic workflow and EHR systems, and the reporting of PRO information. PubMed MEDLINE 190 plus conference abstracts and gray literature 33 ePRO systems reviewed Not specified, conferences 2009–2011 Identified systems were generally developed to improve symptom management, identify psychosocial problems, and facilitate patient-provider communication. Data on actual impact was not part of review scope
Antunes et al. 2014 [57] To systematically identify facilitators and barriers to the implementation of patient-reported outcome measures in different palliative care settings for routine practice Medline, PsycINFO, Cumulative Index to Nursing Allied Health Literature, Embase British Nursing Index 3863 31 1985–2011 There is a need for guidance on implementing PROMs in palliative care clinical practice.
Alsaleh 2013 [23] To review the scientific evidence behind recommending the use of QoL scales routinely in outpatient evaluation. Medline, Embase, PsycINFO 486 6 1990–2012 Evidence for the use of QoL scales in daily clinical practice is limited. Some weak evidence suggesting that this might improve communication between patients and health caregivers. No good evidence that routine administration of QoL questionnaires improve patient’s QoL or changes management. The overall impression is that routine administration of questionnaires in medical oncology outpatient clinics is currently hardly justified.
Luckett et al. 2009 [94] To identify future strategies for PRO interventions to impact patient outcomes in cancer clinics MEDLINE PsycINFO References from earlier review included 576 6 2006–2008 More trials are urgently needed to build a satisfactory evidence base for the routine clinical use of patient-reported data in oncology. Evidence for improvement in patient outcomes as result of PROM use has been limited
Kotronoulas et al. 2014 [34] Is inclusion of PROM in routine clinical practice associated with improvements in patient outcomes, processes of care, and health service outcomes during active anticancer treatment Medline, EMBASE, CINAHL, PsycINFO, PBSC 5015 26 Database inception −2012 Use of PROMs increases the frequency of discussion of patient outcomes. Some support for positive association between use of PROSM and improved symptom control, increased supportive care measures, and patient satisfaction. Need for additional effort to ensure patient adherence and clear system guidelines to guide clinicians response. More research needed to support cost-benefit.
Yang et al. 2017 [58] To identify mechanisms through which PROs facilitate patient-clinician communication in the adult oncology population. MEDLINE, EMBASE, CINAHL, PsycINFO, Cab Direct, CDSR 610 43 Prior to 2016 PROs facilitate patient-clinician communication through various mechanisms that could perhaps contribute to improvements in symptom management and survival. The impact of PROs on clinical outcomes, however, remains poorly studied.
Bouazzaa et al. 2017 [59] To analyze the use of PROMs in the treatment of lung cancer with the aim of improving the quality of care. The secondary objective is to evaluate PROMS currently being used in the care of lung cancer. PubMed, Web of Science and Google Scholar 1118 51 2010–2016 There has yet to be a study on the routine implementation of lung cancer specific PROMs, but PROMs have a promising role.
  1. Abbreviations: EHR = electronic health record, ePRO = electronic patient-reported outcome, EORTC QLQ-C30 = European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30, PRO = patient-reported outcome, PROM = patient-reported outcome measure, QoL = quality of life