Tracking patient-reported symptoms during cancer treatment improved overall patient care, according to a trial published in Nature Medicine.
The use of patient-reported outcomes has grown in recent years, and research has shown that it may improve the quality of care and even extend survival, according to David Cella, PhD, professor of Medical Social Sciences, who was a co-author of the study.
“There are several prior studies, from the U.S., Canada, and France, that have shown how the routine use of patient-reported symptoms in oncology practice can improve quality of life, reduce costly healthcare utilization such as hospitalization, emergency department visits and unscheduled office visits, and in some cases even lengthen life,” Cella said.
Conducted across 52 oncology practices, the current randomized trial compared symptom monitoring using patient-reported outcomes against usual care.
In the study, patients with metastatic cancer were invited to complete weekly symptom surveys, which triggered alerts to the care team for severe or worsening symptoms.
Among the 1,191 enrolled patients, those in the reporting group experienced a delayed time to first emergency visit and fewer emergency visits at 12 months.
Additionally, patients reported significant improvements in physical function, symptom management and health-related quality of life. There was no difference in overall survival between the two groups.
More than 70 percent of study participants said they believed the patient-reported outcomes improved discussions with their care team, according to the findings. More than 80 percent reported feeling more in control of their care and 91 percent recommend the use of patient-reported outcomes to other patients.
These findings suggest that symptom monitoring with patient-reported outcomes may improve the overall quality of cancer care, Cella said.
“We found that the quality of life and healthcare utilization benefits were replicated, but that there was no survival difference between the intervention and control groups,” said Cella, who is also associate director of Cancer Prevention, Control and Survivorship at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “We therefore concluded that future work in this area should focus in on the quality of life and cost-reduction benefits of this approach, understanding that a benefit to survival might or might not be present.”
Cella and his collaborators are now working to implement the use of patient-reported outcomes across Northwestern Medicine oncology clinics.
“We have learned strategies to support clinicians and patients with the technology and clinical workflow required to succeed,” Cella said.
Moving forward, Cella said more work is needed to ensure seamless integration of patient-reported outcomes in oncology care.
“Capturing symptom and function information from patients while we provide care is a logical thing to do, and the evidence points to its value,” Cella said. “That said, achieving a successful approach, whether in oncology or other clinical areas, takes extensive preparation and commitment from all levels of the organization.”
The study was supported by Patient-Centered Outcomes Research Institute grant IHS-1511-33392.
