TY  - JOUR
AU  - Roberts, Natasha Anne
AU  - Pelecanos, Anita
AU  - Alexander, Kimberly
AU  - Wyld, David
AU  - Janda, Monika
PY  - 2024
DA  - 2024/8/27
TI  - Implementation of Patient-Reported Outcomes in a Medical Oncology Setting (the iPROMOS Study): Type II Hybrid Implementation Study
JO  - J Med Internet Res
SP  - e55841
VL  - 26
KW  - implementation science
KW  - iPARIHS
KW  - clinical practice
KW  - intervention
KW  - implementation
KW  - facilitator
KW  - facilitation
KW  - patient-reported outcomes, patient-reported outcome measures
KW  - oncology
KW  - symptom
KW  - symptoms
KW  - detection
KW  - investigate
KW  - service
KW  - services
KW  - clinic
KW  - clinics
KW  - Australia
KW  - binary logistic models
KW  - regression model
KW  - regression models
KW  - patient
KW  - patients
KW  - supportive care
AB  - Background: Clinical trials have demonstrated that patient-reported outcome measures (PROMs) can improve mortality and morbidity outcomes when used in clinical practice. Objective: This study aimed to prospectively investigate the implementation of PROMs in routine oncology. Outcomes measured included improved symptom detection, clinical response to symptom information, and health service outcomes. Methods: Two of 12 eligible clinics were randomized to implement symptom PROMs in a medical oncology outpatient department in Australia. Randomization was carried out at the clinic level. Patients in control clinics continued with usual care; those in intervention clinics completed a symptom PROM at presentation. This was a pilot study investigating symptom detection, using binary logistic models, and clinical response to PROMs investigated using multiple regression models. Results: A total of 461 patient encounters were included, consisting of 242 encounters in the control and 222 in the intervention condition. Patients in these clinics most commonly had head and neck, lung, prostate, breast, or colorectal cancer and were seen in the clinic for surveillance and oral or systemic treatments for curative, metastatic, or palliative cancer care pathways. Compared with control encounters, the proportion of symptoms detected increased in intervention encounters (odds ratio 1.05, 95% CI 0.99-1.11; P=.08). The odds of receiving supportive care, demonstrated by nonroutine allied health review, increased in the intervention compared with control encounters (odds ratio 3.54, 95% CI 1.26-9.90; P=.02). Conclusions: Implementation of PROMs in routine care did not significantly improve symptom detection but increased the likelihood of nonroutine allied health reviews for supportive care. Larger studies are needed to investigate health service outcomes. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618000398202; https://tinyurl.com/3cxbemy4 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e55841
UR  - https://doi.org/10.2196/55841
UR  - http://www.ncbi.nlm.nih.gov/pubmed/39190468
DO  - 10.2196/55841
ID  - info:doi/10.2196/55841
ER  -