Session Item

Patient Reported Outcome Measures (PROMs) are validated questionnaires completed by patients providing a perspective on their current state of health and Quality of Life (QoL). When used in clinical practice, PROMs can monitor for adverse toxicities allowing the early identification of struggling patients. Using PROMs can help improve patient-clinician communication and both patient and health service outcomes. There is increased recognition of the importance of using them in cancer clinical practice, but currently little uptake.

Therefore, we launched an electronic PROMs (ePROMs) service for patients with Head and Neck Cancer (HNC). A pilot preceded this to assess the feasibility and acceptability of ePROMs collection. From this we identified implementation factors that could affect successful uptake. These were then used to guide the initial implementation of the ePROMs service in the HNC clinic.

All patients attending the HNC outpatient clinic for an appointment to see their oncologist were sent a text message with a web link to complete the ePROMs (EORTC QLQ HN43) two days prior via the electronic platform DrDoctor. This was then made available in the electronic health record for real time review and used to guide the clinical consultation. Over 4 weeks, patients who had participated were invited to complete an anonymous satisfaction survey of the process. After 4 months, a feedback session was held with clinicians to obtain feedback and understand their experience of the initial implementation. Analytical data was also collected on completion rates and the time taken to complete the ePROMs.

Between November 2021 and March 2022, 871 text message notifications were sent and a total of 520 were completed giving an overall completion rate of 59.7%. The median time to complete was 6 minutes interquartile range (4 – 9 minutes). From the feedback session with the clinicians, it was clear that the perspective on the value of the ePROMs and their usage varied. Some clinicians felt they increased consultation times as more issues were discussed, while others felt it made the clinic more efficient. 46 patients completed the patient satisfaction survey. The overall feedback was very positive with 95.7% of patients reporting they had a good experience completing the ePROMs. 65.2% felt that it helped them with discussions about their care and treatment.  However, only 30.4% of patients felt that doctors directly discussed the results of the PROMs with them.

The initial experience highlights the importance of maximising clinician engagement by providing education and training on the value of using PROMs and the potential benefits they may have in clinical practice. Efforts should focus on achieving a uniform knowledge base and usage by the clinicians to change current behaviour and improve the proportion of patients who report that clinicians discuss the results of the PROMs with them.