The importance of patient-reported outcome measurements when making clinical decisions: a need for implementation in standard oncological care.


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Charlotte Moss, Ajay Aggarwal, Asad Qureshi, Benjamin Taylor, Teresa Guerrero-Urbano, Mieke Van Hemelrijck

Abstract

Background

Patient reported outcome measurements (PROMs) are emerging as an important component of patient management in the cancer setting, providing broad perspectives on patients’ quality of life and experience. The use of PROMs is, however, generally limited to the context of randomised control trials, as healthcare services are challenged to sustain high quality of care whilst facing increasing demand and financial shortfalls. We performed a systematic review of the literature to identify any oncological benefit of using PROMs and investigate the wider impact on patient experience, in cancers of the pelvic abdominal cavity specifically.  

Method

A systematic review of the literature was conducted using MEDLINE (Pubmed) and Ovid Gateway (Embase and Ovid) until April 2020. Studies investigating the oncological outcomes of PROMs were deemed suitable for inclusion.

Results

A total of 21 studies were included from 2,167 screened articles. Various domains of quality of life (QoL) were identified as potential prognosticators for oncologic outcomes in cancers of the pelvic abdominal cavity: 3 studies identified global QoL as a prognostic factor, 6 studies identified physical and role functioning, and 2 studies highlighted fatigue. In addition to improved outcomes, a number of included studies also reported that the use of PROMs enhanced both patient-clinician communication and patient satisfaction with care in the clinical setting.

Conclusion

This review highlights the necessity of routine collection of PROMs within the pelvic abdominal cancer setting to improve patient quality of life and outcomes. Of note, this review was undertaken during the COVID-19 pandemic when outpatient cancer care underwent a paradigm shift towards telemedicine. This move towards remote working further highlights the necessity of routine collection of PROMs to support cancer patients and allow shared decision making. 

Impact statement

This systematic review of the literature highlights the necessity for routine collection of PROMs within the cancer clinical setting and further work will occur to pilot such collection within a large NHS Cancer Centre.