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Science Nook: Patient-Reported Outcome Measures via E-Health Tools in Cancer Care

As medical care transforms from a disease-centered approach to a patient-centered personalized approach, patient-reported outcome measures (PROMs) may become more beneficial. With the use of PROMs, screening assessments can be done more frequently, patients can be empowered to be involved in their care, and healthcare can be made more efficient. In the below study, the authors assess the acceptability, accuracy, and clinical utility of PROMs using E-Health tools for patients receiving treatment for stomach, colorectal, and pancreatic cancers [i].

Study

Patient-reported outcome measures obtained via E-Health tools ease the assessment burden and encourage patient participation in cancer care (PaCC Study)

Supportive Care in Cancer

This cross-sectional study included 152 individuals undergoing treatment for stomach, colorectal, or pancreatic cancer from outpatient cancer therapy centers in Germany and Switzerland. Participants were provided a tablet to complete 79 questions including acceptability of the tablet-based questionnaires, the Patient Generated Subjective Global Assessment Short Form (PG-SGA SF) for nutrition screening and assessment (weight history, food intake, nutrition impact symptoms, and activities and function), and the distress thermometer (DT) for psycho-social screening assessment. Dietitians completed a nutrition risk assessment using the Nutrition Risk Score (NRS-2002), which includes severity of disease, nutritional status, and age [i].

Findings

The authors found:

1. 89% of participants mostly, or completely, agreed that PROMs through tablets should be integrated into routine clinical care. Younger participants agreed significantly more than older participants, and the level of help needed with completing the questionnaires increased by 3% with each 1 year increase in age

2. Patient-reported nutrition status (PG-SGA SF) was significantly associated with the dietitians’ nutrition risk assessment (NRS-2002)

3. As nutrition status decreased (PG-SGA SF), distress score increased (DT), and activity levels decreased

4. Participants had a good understanding of their nutrition risk — for those that reported feeling well-nourished, PG-SGA SF score was 7.09 points lower than for those that reported not feeling well-nourished

5. 38.2% of all participants requested nutrition supportive care on the same day after completing the questionnaires

6. 48.8% of those who were malnourished and distressed requested same day supportive care [i]


For the Patient and Caregiver

PROMs, particularly via E-Health tools, may automate early identification of nutrition status and facilitate a treatment plan for cancer patients. With early intervention, patients’ nutrition can be optimized to prevent weight loss and malnutrition. It is worth considering if you, as a patient or caregiver, feel comfortable using technology platforms. If not, this may be more important to distinguish in your care in the future.

For the Healthcare Team

Consider if PROMs via E-Health tools is currently used in your practice, or if it has the potential to be integrated into your practice as a screening tool for nutrition status and mental health status. If you are currently using PROMs via E-Health tools, it may be important to discuss with patients if they are familiar with using the technology, particularly for older patients. PROMs in combination with patient-centered care from healthcare providers may further optimize oncology care.


Reference:

[i] Erickson N, Schinkoethe T, Eckhardt C, Storck L, Joos A, Liu L…Heinemann V (2021). Patient-reported outcome measures obtained via E-Health tools ease the assessment burden and encourage patient participation in cancer care (PaCC Study). Supportive Care in Cancer, 29(12):7715-7724. https://doi.org/10.1007/s00520-021-06351-1

Jenna Koroly, MS, RD, CDN

Jenna is a Registered Dietitian with a Master’s of Science in Nutrition and Exercise Physiology from Teachers College, Columbia University. She has been a part of the Savor Health team since October 2016, and gained further clinical knowledge in oncology while performing nutrition assessments at Northern Westchester Hospital and Amsterdam Nursing Home as a dietetic intern. Jenna provides nutrition counseling for patients in Medical Weight Management and Bariatric Surgery settings at Brigham & Women's Hospital in Boston. She is passionate about nutrition therapy and exercise for oncology patients.

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