Sasja A Schepers1,2, Simone M Sint Nicolaas3, Lotte Haverman1, Michel Wensing4, Antoinette Y N Schouten van Meeteren5, Margreet A Veening6, Huib N Caron5, Peter M Hoogerbrugge2, Gertjan J L Kaspers2,6, Christianne M Verhaak3, Martha A Grootenhuis1,2. 1. Psychosocial Department, Academic Medical Center/Emma Children's Hospital, Amsterdam, the Netherlands. 2. Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. 3. Department of Medical Psychology, Radboud University Medical Center/Amalia Children's Hospital, Nijmegen, the Netherlands. 4. Scientific Institute for Quality, Radboud University Medical Centre, Nijmegen, the Netherlands. 5. Department of Pediatric Oncology, Academic Medical Center/Emma Children's Hospital, Amsterdam, the Netherlands. 6. Department of Pediatrics, Division of Oncology/Hematology VU University Medical Center, Amsterdam, the Netherlands.
Abstract
OBJECTIVE: The KLIK method is an online tool that monitors and discusses electronic patient-reported outcomes (ePROs), which has been shown to enhance outcomes. This study aimed (1) to determine the fidelity (ie, extent to which used as intended) of the KLIK method as implemented in outpatient pediatric cancer care and (2) to study health care professional (HCP)-reported barriers and facilitators for implementation. METHODS: Two hundred five children with newly diagnosed cancer (enrollment rate 85%) participated. At 1 (T1), 3 (T2), and 6 (T3) months after diagnosis, patients (8-18 years) or parents (of patients 0-7 years) completed health-related quality of life (HRQoL) questionnaires, which were transformed into an ePROfile and discussed by their HCP during consultations. Fidelity was determined by the following: percentage of website registrations, HRQoL questionnaires completed, and ePROfiles discussed. Implementation determinants were assessed with HCPs after the final T3 with the Measurement Instrument for Determinants of Innovations. RESULTS: Depending on the time point (T1-T3), fidelity was 86% to 89% for website registration, 66-85% for completed HRQoL questionnaires, and 56% to 62% for ePROfile discussion. Barriers were mainly related to organizational issues (eg, organizational change) and less frequently to users (eg, motivation to comply) or the intervention (compatibility). Facilitators were related to the user (eg, positive outcome expectations) and intervention (simplicity) but not to the organization. CONCLUSIONS: When implementing ePROs in outpatient pediatric oncology practice, HCPs report determinants that influence ePRO integration. To improve implementation and outcomes, tailored organizational (eg, formal ratification by management and time) and specific local (eg, individualized assessments) strategies should be developed to achieve optimal ePRO discussion.
OBJECTIVE: The KLIK method is an online tool that monitors and discusses electronic patient-reported outcomes (ePROs), which has been shown to enhance outcomes. This study aimed (1) to determine the fidelity (ie, extent to which used as intended) of the KLIK method as implemented in outpatient pediatric cancer care and (2) to study health care professional (HCP)-reported barriers and facilitators for implementation. METHODS: Two hundred five children with newly diagnosed cancer (enrollment rate 85%) participated. At 1 (T1), 3 (T2), and 6 (T3) months after diagnosis, patients (8-18 years) or parents (of patients 0-7 years) completed health-related quality of life (HRQoL) questionnaires, which were transformed into an ePROfile and discussed by their HCP during consultations. Fidelity was determined by the following: percentage of website registrations, HRQoL questionnaires completed, and ePROfiles discussed. Implementation determinants were assessed with HCPs after the final T3 with the Measurement Instrument for Determinants of Innovations. RESULTS: Depending on the time point (T1-T3), fidelity was 86% to 89% for website registration, 66-85% for completed HRQoL questionnaires, and 56% to 62% for ePROfile discussion. Barriers were mainly related to organizational issues (eg, organizational change) and less frequently to users (eg, motivation to comply) or the intervention (compatibility). Facilitators were related to the user (eg, positive outcome expectations) and intervention (simplicity) but not to the organization. CONCLUSIONS: When implementing ePROs in outpatient pediatric oncology practice, HCPs report determinants that influence ePRO integration. To improve implementation and outcomes, tailored organizational (eg, formal ratification by management and time) and specific local (eg, individualized assessments) strategies should be developed to achieve optimal ePRO discussion.
Authors: Jordan Gilleland Marchak; Sean N Halpin; Cam Escoffery; Shadé Owolabi; Ann C Mertens; Karen Wasilewski-Masker Journal: Psychooncology Date: 2020-10-20 Impact factor: 3.894
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Authors: Erica Sood; Amy Jo Lisanti; Sarah E Woolf-King; Jo Wray; Nadine Kasparian; Emily Jackson; Mary R Gregory; Keila N Lopez; Bradley S Marino; Trent Neely; Amy Randall; Sinai C Zyblewski; Cheryl L Brosig Journal: Cardiol Young Date: 2021-06-04 Impact factor: 1.093
Authors: Elizabeth D Cox; Sarah K Dobrozsi; Christopher B Forrest; Wendy E Gerhardt; Harald Kliems; Bryce B Reeve; Nan E Rothrock; Jin-Shei Lai; Jacob M Svenson; Lindsay A Thompson; Thuy Dan N Tran; Carole A Tucker Journal: J Pediatr Date: 2020-11-30 Impact factor: 4.406
Authors: Emiel Boogerd; Nienke M Maas-Van Schaaijk; Theo C Sas; Agnes Clement-de Boers; Mischa Smallenbroek; Roos Nuboer; Cees Noordam; Chris M Verhaak Journal: J Med Internet Res Date: 2017-08-22 Impact factor: 5.428
Authors: Sasja A Schepers; Simone M Sint Nicolaas; Heleen Maurice-Stam; Elisabeth M van Dijk-Lokkart; Esther M M van den Bergh; Nienke de Boer; Chris M Verhaak; Martha A Grootenhuis Journal: Support Care Cancer Date: 2017-05-11 Impact factor: 3.603
Authors: S A Schepers; H A van Oers; H Maurice-Stam; J Huisman; C M Verhaak; M A Grootenhuis; L Haverman Journal: Health Qual Life Outcomes Date: 2017-04-24 Impact factor: 3.186