Implementation of electronic patient-reported outcomes in head and neck oncology at a comprehensive cancer center.

Authors

null

Nadine Jackson McCleary

Dana Farber Cancer Institute, Boston, MA

Nadine Jackson McCleary , Rosh K Sethi , Ravindra Uppaluri , Sarah Whittaker , Jessica Cleveland , Brittany Black , Sunyi Zhang , Michael J. Hassett , Laura A. Goguen

Organizations

Dana Farber Cancer Institute, Boston, MA, Brigham and Women's Hospital, Boston, MA, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, MA, Mass General Brigham, Boston, MA, Dana-Farber Cancer Institute, Boston, MA

Research Funding

No funding received

Background: Monitoring electronic patient reported outcomes (ePROs) has demonstrated impact on quality of life and survival in oncology. Maintaining high response rates to ePRO measures is critical in routine care. We evaluate the routine care implementation of head and neck oncology (HNO)-focused ePROs and the impact of patient demographics and assignment method on response rate. Methods: Since October 2021, patients diagnosed with head and neck cancer (PHN) at Dana-Farber Cancer Institute (DFCI) have had the opportunity to respond to the EHR-integrated European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ- H&N43) at clinic visits, not to exceed every 30 days. PHN are also prompted at 7 and 14 days postoperative, regardless of clinic visit. HNO clinicians selected EORTC QLQ- H&N43 because of its actionable scores and limited overlap with cross-cutting ePRO tools at DFCI. Reviewed by Patient and Family Advisory Council members, PHN can respond to the questionnaire in English or Spanish via any internet-enabled device or tablet provided in clinic. Tablet assignment rates are sent via automated report to the HNO clinic manager. Results: Between October 2021 and January 2022, PHN responded to 64% of questionnaires for eligible clinic visits (1618/2535). Post-operatively, 65% of PHN responded to EORTC QLQ- H&N43 at least once within 28 days of surgery. Prompted at 7 and 14 days, PHN responded to 44% (133/300) of all post-operative questionnaires. Overall, PHN responded on their own device 50% of the time and on tablets in clinic 50% of the time. Response rates significantly associated with race, primary language, and age at clinic, but not post-operatively due to low sample size. PHN with a primary language other than English, older PHN, and PHN with races other than white responded less frequently, with the exception of Asian PHN in clinic who had the highest response rates. Clinician champions, EHR-integration, and a timely feedback loop to clinic managers facilitated response rates. Conclusions: Successful implementation of HNO ePROs is aided by clinical engagement and availability of real-time response rate data. ePRO response rate in HNO was found to be associated with race, primary language, age, and assignment method. Further work to focus on improving disparities within response rates and linking automatic interventions to scores is needed.

Characteristic
Clinic Response Rate (%)
Post-operative Response Rate (%)
Race

P-value

Clinic: <0.001

Post-op: 0.19
White
65 (1447/2219)
46 (121/261)

Asian
67 (66/99)
36 (4/11)

Black
48 (29/61)
17 (2/12)

Other
49 (76/156)
38 (6/16)
Primary Language

P-value

Clinic: <0.001

Post-op: 0.25
English
66 (1545/2354)
46 (124/271)

Spanish
36 (23/64)
40 (4/10)

Other
43 (50/117)
26 (5/19)
Age (yr)

P-value

Clinic: 0.01

Post-op: 0.47
<70
66 (1112/1697)
45 (105/231)

≥70
60 (506/838)
41 (28/69)

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Palliative Care and Symptom Management

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 12115)

DOI

10.1200/JCO.2022.40.16_suppl.12115

Abstract #

12115

Poster Bd #

359

Abstract Disclosures

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