Markus Schuler1, Freya Trautmann2, Mirko Radloff3, Leopold Hentschel4, Thomas Petzold5, Maria Eberlein-Gonska6, Gerhard Ehninger4, Jochen Schmitt7. 1. Department of Internal Medicine I, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany; Clinic for Internal Medicine II, HELIOS Hospital Emil von Behring, Berlin, Germany. 2. Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), partner site Dresden and German Cancer Research Center (DKFZ) Heidelberg, Dresden, Germany. Electronic address: freya.trautmann@uniklinikum-dresden.de. 3. Department of Internal Medicine I, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany. 4. Department of Internal Medicine I, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany; University CancerCenter, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany. 5. Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany; Department of Quality and Medical Risk Management, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany. 6. Department of Quality and Medical Risk Management, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany. 7. Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), partner site Dresden and German Cancer Research Center (DKFZ) Heidelberg, Dresden, Germany; University CancerCenter, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.
Abstract
BACKGROUND: Inclusion of patient-reported outcomes (PROs) in routine cancer care is of key importance for individualized treatment, shared decision making and patient satisfaction. OBJECTIVE: To describe the implementation under routine conditions of an electronic self-administered PRO assessment and comparison of PROs before and after inpatient treatment in oncologic care. METHODS: In a tablet-based survey PROs on symptom burden, global health status/ quality of life (QoL) and health utility were collected twice (at hospital admission and discharge) in an inpatient oncological setting over a 17-month period using the EORTC QLQ-C30 and EQ-5D questionnaires. Data were linked to the hospital information system (HIS). Patient acceptability, recruitment rates, symptom burden, and clinically meaningful changes in PROs over time were analyzed. RESULTS: From a total of 384 hospitalized patients invited to participate at admission 371 (96.6 %) participated. At discharge, 195 patients were approached for a follow-up assessment, and 192 patients (98.5 %) participated. Despite strong acceptance among patients, recruitment rates were decreasing over time. During the hospital stay clinically meaningful improvements were observed for health utility (33.3 %, n = 64) and global health status/QoL (43.2 %, n = 83). Patients reported a variety of symptoms at admission and discharge. CONCLUSIONS: Implementation of PRO assessment in routine care and data integration into the HIS provides valuable information for the entire medical staff as symptom burden is present during the entire hospital stay. IMPLICATIONS FOR PRACTICE: Long-term maintenance of PRO assessment in a clinical setting as a prerequisite of value-based healthcare requires continuous involvement of the nursing team, which can only be achieved by allocating resources to this task.
BACKGROUND: Inclusion of patient-reported outcomes (PROs) in routine cancer care is of key importance for individualized treatment, shared decision making and patient satisfaction. OBJECTIVE: To describe the implementation under routine conditions of an electronic self-administered PRO assessment and comparison of PROs before and after inpatient treatment in oncologic care. METHODS: In a tablet-based survey PROs on symptom burden, global health status/ quality of life (QoL) and health utility were collected twice (at hospital admission and discharge) in an inpatient oncological setting over a 17-month period using the EORTC QLQ-C30 and EQ-5D questionnaires. Data were linked to the hospital information system (HIS). Patient acceptability, recruitment rates, symptom burden, and clinically meaningful changes in PROs over time were analyzed. RESULTS: From a total of 384 hospitalized patients invited to participate at admission 371 (96.6 %) participated. At discharge, 195 patients were approached for a follow-up assessment, and 192 patients (98.5 %) participated. Despite strong acceptance among patients, recruitment rates were decreasing over time. During the hospital stay clinically meaningful improvements were observed for health utility (33.3 %, n = 64) and global health status/QoL (43.2 %, n = 83). Patients reported a variety of symptoms at admission and discharge. CONCLUSIONS: Implementation of PRO assessment in routine care and data integration into the HIS provides valuable information for the entire medical staff as symptom burden is present during the entire hospital stay. IMPLICATIONS FOR PRACTICE: Long-term maintenance of PRO assessment in a clinical setting as a prerequisite of value-based healthcare requires continuous involvement of the nursing team, which can only be achieved by allocating resources to this task.
Authors: David J Weiss; Chun Wang; Jeffrey R Basford; King Yiu Suen; Isabella M Alvarado; Andrea Cheville Journal: Arch Phys Med Rehabil Date: 2021-10-01 Impact factor: 4.060
Authors: Leopold Hentschel; Stephan Richter; Hans-Georg Kopp; Bernd Kasper; Annegret Kunitz; Viktor Grünwald; Torsten Kessler; Jens Marcus Chemnitz; Uwe Pelzer; Ulrich Schuler; Janet Freitag; Andrea Schilling; Beate Hornemann; Karin Arndt; Martin Bornhäuser; Markus Kajo Schuler Journal: BMJ Open Date: 2020-08-27 Impact factor: 2.692